Individual provider Active NPI

Morgan Altamirano, AGACNP-C

  • Nurse Practitioner
  • Canton, GA
National Provider Identifier
1114606910
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
GAA-NP001401 Issued in GA
Practice address
470 Northside Cherokee Blvd Ste 480
Canton, GA 30115-8034
Phone
(404) 962-6000
NPI assigned
Jul 18, 2023
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X GAA-NP001401 GA Primary
Acute Care Nurse Practitioner 363LA2100X GAA-NP001401 GA

Addresses

Primary practice location

470 Northside Cherokee Blvd Ste 480
Canton, GA 30115-8034

Mailing address

470 Northside Cherokee Blvd Ste 480
Canton, GA 30115-8034
Phone (404) 962-6000

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
I20230815002020 GA Practitioner - Nurse Practitioner 0648632182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
67.82
Promoting interoperability
77
Improvement activities
40
Cost
77.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP001401GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Cardiovascular Professional Services, LLC CurrentSince Sep 27, 2023 Accepting new patients

Locations

1110 W Peachtree St NW
Ste 920
Atlanta, GA 30309

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

470 Northside Cherokee Blvd
Ste 480
Canton, GA 30115

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1114606910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 480",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158034",
            "telephone_number": "404-962-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 480",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158034",
            "telephone_number": "404-962-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAMIRANO",
        "first_name": "MORGAN",
        "credential": "AGACNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP001401",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "GAA-NP001401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.