Irine Alfred
Individual provider Active NPI Primary Care Nurse Practitioner · Decatur, GA
NPI 1114758554 · NPPES record last updated Aug 8, 2024
Key facts
- NPI
- 1114758554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- RN271360 (GA)
- Practice address
- 1670 Clairmont Rd
Decatur, GA 30033-4004 - Phone
- (404) 315-4100
- NPI assigned
- Aug 8, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
19324 Deer TRL
Alpharetta, GA 30004-5021
965 Oakland Rd
Suite 3D
Lawrenceville, GA 30044-3758
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251126000525 | GA | Practitioner - Nurse Practitioner | 5890287833 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN271360 | GA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zam Zam Family Clinic LLC | Current |
Accepting new patients |
Locations
965 Oakland Rd
Ste 3E
Lawrenceville, GA 30044
Phone (470) 818-8607
965 Oakland Rd
Ste 3D
Lawrenceville, GA 30044
Phone (770) 495-9775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RN271360 | GA | Yes |
Addresses
Primary practice location
1670 Clairmont Rd
Decatur, GA 30033-4004
Mailing address
1670 Clairmont Rd
Decatur, GA 30033-4004
Other providers in Decatur, GA
- James Washington Alexander
- Robert Ray Alexander
- Ruben Antonio Alexander
- Jessica Arnee Alford
- Tysheana Jnai Alford
- Mohammed Kumail Ali
- Nadia Ali
- Zaan Z Ali
- Joanna Pamela Alicea
- Alig Orthopedics LLC
All providers in Decatur, GA · Primary Care Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.