Individual provider Active NPI

Kizzy Ohenewaa Ayim-Dakwa, FNP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1043795776
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
241208 Issued in GA
Practice address
3637 Peachtree Rd NE
Atlanta, GA 30319-1252
Phone
(404) 926-3541
NPI assigned
Sep 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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 241208 GA Primary

Addresses

Primary practice location

3637 Peachtree Rd NE
Atlanta, GA 30319-1252

Mailing address

5526 Parkerton LN
Sandy Springs, GA 30342-5037
Phone (678) 979-7629

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
I20181201000014 GA Practitioner - Nurse Practitioner 6901140979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

11710 Alpharetta Hwy
Roswell, GA 30076-3807
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
241208GAMDFamily Nurse Practitioner

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Oct 18, 2018 Accepting new patients
Primary Care PLLC Family CurrentSince Oct 17, 2024 Accepting new patients

Locations

3637 Peachtree Rd NE
Atlanta, GA 30319
Phone (404) 926-3541

865 N Highland Ave NE
Atlanta, GA 30306
Phone (404) 733-6089

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1043795776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5526 PARKERTON LN",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303425037",
            "telephone_number": "678-979-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303191252",
            "telephone_number": "404-926-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYIM-DAKWA",
        "first_name": "KIZZY",
        "middle_name": "OHENEWAA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "241208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.