Vallery Isoken Enoghabun, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN272377 Issued in GA

Practice address

915 Interstate Ridge Dr
Gainesville, GA 30501-7076

Phone

(678) 207-2900

NPI assigned

Jul 23, 2022

Sex

Female

Sole proprietor

No

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia Mountains Community ServicesGroup PAC ID 8921094400, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Georgia Mountains Community Services

  • Mental Health Counselor
  • Cumming, GA
  • NPI 1063522035
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1658534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1043945918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 INTERSTATE RIDGE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017076",
            "telephone_number": "678-207-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 INTERSTATE RIDGE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017076",
            "telephone_number": "678-207-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENOGHABUN",
        "first_name": "VALLERY",
        "middle_name": "ISOKEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-23",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN272377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerri Emory, SA-C
• Bryan Scott Engel, NP-C
• Brandon Chase England, CRNA
• Tamara English, LPC
• Martha Pittman Engstrom
• ENT,Sinus&Allergy Specialists
• Seth E. Enterline, PA
• Fasika T Enyew, FNP-C
• Marc Douglas Erickson, MD
• Dale R Erwin, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.