Individual provider Active NPI

Irene Obiageri Ibenyenwa, FNP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1023661816
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
184698 Issued in GA
Practice address
4300 Paces Ferry Rd SE
Atlanta, GA 30339-5703
Phone
(678) 390-4149
Fax
(678) 737-1729
NPI assigned
Jul 20, 2019
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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 184698 GA Primary

Addresses

Primary practice location

4300 Paces Ferry Rd SE
Atlanta, GA 30339-5703

Mailing address

4300 Paces Ferry Rd SE
Atlanta, GA 30339-5703
Phone (678) 390-4149

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
I20191016003827 GA Practitioner - Nurse Practitioner 3678804994 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
184698GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Xanbody LLC CurrentSince May 28, 2025 Accepting new patients
True North Health Navigation LLC CurrentSince Apr 1, 2024 Accepting new patients
True North Health Navigation LLC CurrentSince Apr 1, 2024 Accepting new patients
TLC of Georgia LLC Family CurrentSince May 2, 2021 Accepting new patients
SF Georgia Medical Services PC CurrentSince Aug 3, 2019 Accepting new patients

Locations

2903 Stirling Rd
Fort Lauderdale, FL 33312
Phone 2124198180 ext. 98180

22 Maple Ridge Dr
Cartersville, GA 30121
Phone (770) 606-8800

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

1 W Court Sq
Ste 750
Decatur, GA 30030
Phone (404) 494-7888

1350 Wooten Lake Rd NW
Kennesaw, GA 30144

1350 Wooten Lake Rd NW
Ste 204
Kennesaw, GA 30144
Phone (678) 402-1389

5885 Glenridge Dr
Ste 100
Sandy Springs, GA 30328
Phone (678) 321-8546

3240 S Cobb Dr SE
Smyrna, GA 30080
Phone (770) 433-3420

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a74b5677-a506-4100-881e-d18e68399558/
  • Direct secure messaging: irene.ibenyenwa.1@13869.direct.athenahealth.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1023661816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395703",
            "telephone_number": "678-390-4149",
            "fax_number": "678-737-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395703",
            "telephone_number": "678-390-4149",
            "fax_number": "678-737-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBENYENWA",
        "first_name": "IRENE",
        "middle_name": "OBIAGERI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-20",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "184698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.