Active NPI
Abosede Haygood
- Psychiatric/Mental Health Nurse Practitioner
- Ellenwood, GA
National Provider Identifier
1215639612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2022096900
- Practice address
- 4639 River Hill Cir
Ellenwood, GA 30294-1884 - Phone
- (404) 259-0967
- NPI assigned
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2022096900 | GA | Primary |
Addresses
Primary practice location
4639 River Hill Cir
Ellenwood, GA 30294-1884
Mailing address
4639 River Hill Cir
Ellenwood, GA 30294-1884
Phone (404) 259-0967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022096900 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1215639612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4639 RIVER HILL CIR",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302941884",
"telephone_number": "404-259-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4639 RIVER HILL CIR",
"city": "ELLENWOOD",
"state": "GA",
"postal_code": "302941884",
"telephone_number": "404-259-0967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYGOOD",
"first_name": "ABOSEDE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "GA",
"license": "2022096900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellenwood, GA
- Santrell Denise Hart-Moreland, O.D.,M.P.H.
- Harvestlodge Homes and Services for Children and Families
- Kamica Ross Hatchett, CRNA
- Lenora Hawkins
- Dwight D Hayes, PHARM D
- Kathleen C Haynes, FNP
- Heavenly Angels Home of Care PCH, LLC
- Naomi Hemphill, LCSW
- Vonda S Hendrickson, LMT
- Tennille Morris Hicks, FNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.