Mone Ancrum

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

4245 Windale Dr
Lawrenceville, GA 30044-6869

Phone

(678) 777-2665

Fax

(404) 393-0686

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Fettii

  • Prosthetic/Orthotic Supplier
  • Lawrenceville, GA
  • NPI 1962920215
  NPD Authorized official

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043738362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 WINDALE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300446869",
            "telephone_number": "678-777-2665",
            "fax_number": "404-393-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 WINDALE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300446869",
            "telephone_number": "678-777-2665",
            "fax_number": "404-393-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCRUM",
        "first_name": "MONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl Amoako, FNP
• Beatriz Albuquerque Amorim, RBT
• Kwasi K. Ampomah
• Amy Profesorsky
• Jong An
• Allison Nicole Anderson, P.A-C
• Amy Anderson, PT, DPT
• Blessing Adeagbo Anderson
• Dana Anderson
• David Nelson Anderson, MD

• Prosthetic/Orthotic Supplier in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.