Individual provider Active NPI

Marc Elie Cayemitte, AGNP-C

  • Gerontology Nurse Practitioner
  • Stone Mountain, GA
National Provider Identifier
1073327664
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG01250064 Issued in GA
Practice address
5462 Memorial Dr Ste 101
Stone Mountain, GA 30083-3239
Phone
(470) 544-0854
NPI assigned
Feb 4, 2025
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG01250064 GA Primary

Addresses

Primary practice location

5462 Memorial Dr Ste 101
Stone Mountain, GA 30083-3239

Mailing address

1080 W Peachtree St NW Unit 708
Atlanta, GA 30309-3830
Phone (773) 895-8542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG01250064GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Harm Reduction Coalition Inc PastSince Feb 9, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marc.cayemitte.1@31171.direct.athenahealth.com

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, 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": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1073327664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 W PEACHTREE ST NW UNIT 708",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093830",
            "telephone_number": "773-895-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "470-544-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAYEMITTE",
        "first_name": "MARC",
        "middle_name": "ELIE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "AG01250064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.