Individual provider Active NPI

Asata Kamara, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Stone Mountain, GA
National Provider Identifier
1124412788
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN169167 Issued in GA
Practice address
5300 Memorial Dr Ste 101
Stone Mountain, GA 30083-3154
Phone
(470) 918-9719
NPI assigned
Mar 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 169167 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN169167 GA Primary

Addresses

Primary practice location

5300 Memorial Dr Ste 101
Stone Mountain, GA 30083-3154

Mailing address

5300 Memorial Dr Ste 101
Stone Mountain, GA 30083-3154
Phone (470) 918-9719

Other practice location 1

3424 Flat Shoals Rd
Decatur, GA 30034-6525
Phone (404) 968-8269

Other practice location 2

367 Resource Pkwy
Winder, GA 30680-8364
Phone (404) 819-8701

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
I20170131000131 GA Practitioner - Nurse Practitioner 4688956493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5300 Memorial Dr
Suite 101
Stone Mountain, GA 30083-3154
Phone (470) 918-9719

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169167GAMDFamily Nurse Practitioner
RN169167GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nimba Integrative Practice LLC Psychiatric/Mental Health CurrentSince Mar 15, 2023 Accepting new patients
Atlanta Family Physicians PC CurrentSince Nov 6, 2016 Accepting new patients
Atlanta Health Unlimited Past Accepting new patients

Locations

3424 Flat Shoals Rd
Decatur, GA 30034
Phone (404) 241-5304

5300 Memorial Dr
Ste 101
Stone Mountain, GA 30083
Phone (470) 918-9719

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1124412788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833154",
            "telephone_number": "470-918-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833154",
            "telephone_number": "470-918-9719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3424 Flat Shoals Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300346525",
            "country_code": "US",
            "telephone_number": "404-968-8269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "367 Resource Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winder",
            "state": "GA",
            "postal_code": "306808364",
            "country_code": "US",
            "telephone_number": "404-819-8701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMARA",
        "first_name": "ASATA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2023-10-11",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "169167",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN169167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.