Active NPI
Merit Health
- Family Nurse Practitioner
- Powder Springs, GA
National Provider Identifier
1235831512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- MERIT HEALTH
- Doing business as
- Merit Health
- Practice address
- 4910 Brown Leaf Dr
Powder Springs, GA 30127-8918 - Phone
- (404) 693-5565
- Fax
- (920) 212-2048
- NPI assigned
- Mar 20, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Igwebuike Moses Udeze, APRN
- Title
- Ceo
- Phone
- (404) 693-5565
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
4910 Brown Leaf Dr
Powder Springs, GA 30127-8918
Mailing address
3721 New Macland Rd Ste 200-193
Powder Springs, GA 30127-2000
Phone (404) 693-5565
Other names 1
- Merit Health
National Provider Directory
National Provider DirectoryLocations
3721 New Macland Rd
Ste 200193
Powder Springs, GA 30127
Phone (404) 693-5565
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679270400000",
"number": "1235831512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3721 NEW MACLAND RD STE 200-193",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301272000",
"telephone_number": "404-693-5565",
"fax_number": "920-212-2048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 BROWN LEAF DR",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301278918",
"telephone_number": "404-693-5565",
"fax_number": "920-212-2048"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERIT HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-20",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A",
"authorized_official_last_name": "UDEZE",
"authorized_official_first_name": "IGWEBUIKE",
"authorized_official_middle_name": "MOSES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "404-693-5565",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Merit Health",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Powder Springs, GA
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.