Individual provider Active NPI

Lemlem Ashenafi Mamo, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1164085320
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
92170 Issued in GA
Practice address
303 Parkway Dr NE FL 4
Atlanta, GA 30312-1212
Phone
(404) 265-4919
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 92170 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

303 Parkway Dr NE FL 4
Atlanta, GA 30312-1212

Mailing address

304 Turner McCall Blvd SW
Rome, GA 30165-5621

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020001185 GA Practitioner - Internal Medicine 4880060532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-4340

Hospital & facility affiliations

  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
92170GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC CurrentSince Aug 24, 2022 Accepting new patients
24 On Physicians, P.C. CurrentSince Aug 24, 2022 Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1164085320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 TURNER MCCALL BLVD SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKWAY DR NE FL 4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121212",
            "telephone_number": "404-265-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMO",
        "first_name": "LEMLEM",
        "middle_name": "ASHENAFI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "92170",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.