Individual provider Active NPI

Susan Wanjiku Kamau, FNP

  • Family Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1013523646
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN251277 Issued in GA
Practice address
1579 Sage Ridge Dr
Marietta, GA 30064-5327
Phone
(404) 643-0444
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN251277 GA Primary

Addresses

Primary practice location

1579 Sage Ridge Dr
Marietta, GA 30064-5327

Mailing address

1579 Sage Ridge Dr
Marietta, GA 30064-5327
Phone (404) 643-0444

Other names 1

  • Susan Wanjiku Kamau Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129000576 GA Practitioner - Nurse Practitioner 1052760949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Dec 5, 2023 Accepting new patients

Locations

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: ms_skamau2@landmarkhealth-direct.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1013523646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 SAGE RIDGE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645327",
            "telephone_number": "404-643-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 SAGE RIDGE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645327",
            "telephone_number": "404-643-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAU",
        "first_name": "SUSAN",
        "middle_name": "WANJIKU",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN251277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KAMAU",
            "middle_name": "WANJIKU",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.