Active NPI
Sandra I Agazie
- Psychiatric/Mental Health Nurse Practitioner
- Fayetteville, GA
National Provider Identifier
1093506701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN170528
- Practice address
- 115 Bradford SQ Ste B
Fayetteville, GA 30215-1962 - Phone
- (404) 736-4343
- Fax
- (844) 870-7142
- NPI assigned
- May 13, 2025
- Last updated
- Aug 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN170528 | GA | |
| Adult Health Nurse Practitioner | 363LA2200X | RN170528 | GA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN170528 | GA | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | RN170528 | GA | |
| Registered Nurse | 163W00000X | RN170538 | GA | |
| Medical-Surgical Registered Nurse | 163WM0705X | RN170538 | GA |
Addresses
Primary practice location
115 Bradford SQ Ste B
Fayetteville, GA 30215-1962
Mailing address
7586 Oldham LN
Riverdale, GA 30274-3595
Phone (404) 736-4343
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003133861A | Medicaid | GA | |
| 0031333861D | Medicaid | GA | |
| 003133861B | Medicaid | GA | |
| 003315273A | Medicaid | GA | |
| 003149239A | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN170538 | GA | MD | Medical-Surgical Registered Nurse |
| RN170528 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanzie Healthcare Services, Inc | Registered Nurse | Current | Accepting new patients |
Locations
115 Bradford Sq
Ste B
Fayetteville, GA 30215
Phone (404) 736-4343
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": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1093506701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7586 OLDHAM LN",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302743595",
"telephone_number": "404-736-4343",
"fax_number": "844-270-7142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 BRADFORD SQ STE B",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302151962",
"telephone_number": "404-736-4343",
"fax_number": "844-870-7142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGAZIE",
"first_name": "SANDRA",
"middle_name": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-13",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN170528",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "GA",
"license": "RN170528",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "GA",
"license": "RN170528",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "GA",
"license": "RN170528",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN170538",
"primary": false
},
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "GA",
"license": "RN170538",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003133861A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0031333861D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003133861B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003315273A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003149239A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
- Advanced Physical Therapy of Fayette, LLC
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- Agape Speech Therapy, LLC
- Agape Sports Performance Wellness and Rehab
- Amita Agarwal, OTR,CHT
- Fatimat Olumayowa Olufunmilayo Agbojeyin
- Chanda Agee, LPN
- Ali Ahmad, MD
- Taiwo Aigberua, PHARMD
- Joan O. Aina, DNP,FNP, PMHNP, CWS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.