Individual provider Active NPI

Serwah Sarponma Amponsah, FNP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1194350546
Registry record updated Mar 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN192949 Issued in GA
Practice address
6070 Lakeside Commons Dr
Macon, GA 31210-5778
Phone
(478) 254-2644
NPI assigned
Mar 5, 2020
Last updated
Mar 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN192949 GA Primary

Addresses

Primary practice location

6070 Lakeside Commons Dr
Macon, GA 31210-5778

Mailing address

701 Avenue St
McDonough, GA 30253-7629
Phone (678) 708-8480

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
I20200601002730 GA Practitioner - Nurse Practitioner 5193146082 Reassigns benefits to 1 organization
Practice locations: Macon, GA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Family Medical and Urgent Care Clinic of McDonough, LLCGroup PAC ID 7113054131, 20 clinicians

Practice addresses (Care Compare)

1631 Hwy 20 W
McDonough, GA 30253-7311
Phone (770) 288-2822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN192949GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical and Urgent Care Clinic of McDonough, LLC CurrentSince Jul 5, 2021 Accepting new patients
Family Medical Associates, LLC CurrentSince Jul 5, 2021 Accepting new patients

Locations

1631 Highway 20 W
McDonough, GA 30253
Phone (770) 288-2822

230 Plaza Dr
Zebulon, GA 30295
Phone (404) 569-1310

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJFBD
  • Direct secure messaging: serwah.amponsah@familyhc.eclinicaldirectplus.com

Organizations & group practices 2

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1194350546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 AVENUE ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537629",
            "telephone_number": "678-708-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 LAKESIDE COMMONS DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105778",
            "telephone_number": "478-254-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMPONSAH",
        "first_name": "SERWAH",
        "middle_name": "SARPONMA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN192949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.