Individual provider Active NPI

Leonie Ntsah Fobuzie

  • Skilled Nursing Facility
  • Kennesaw, GA
National Provider Identifier
1225368749
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
RN185513 Issued in GA
Practice address
353 Heritage Park Trce NW
Kennesaw, GA 30144-4832
Phone
(404) 668-8461
NPI assigned
Jan 5, 2010
Last updated
Jan 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X RN185513 GA Primary
Skilled Nursing Facility 314000000X RN9294975 FL

Addresses

Primary practice location

353 Heritage Park Trce NW
Kennesaw, GA 30144-4832

Mailing address

353 Heritage Park Trce NW
Kennesaw, GA 30144-4832
Phone (404) 668-8461

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

LicenseStateTypeSpecialty
RN9294975FLMDSkilled Nursing Facility
RN185513GAMDSkilled Nursing Facility

Organizations & group practices 1

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1225368749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 HERITAGE PARK TRCE NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444832",
            "telephone_number": "404-668-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 HERITAGE PARK TRCE NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444832",
            "telephone_number": "404-668-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOBUZIE",
        "first_name": "LEONIE",
        "middle_name": "NTSAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "RN185513",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "RN9294975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.