Individual provider Active NPI

Amartha Ezinne Ogburu, NP

  • Family Nurse Practitioner
  • Woodstock, GA
National Provider Identifier
1235929969
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN253492 Issued in GA
Practice address
502 Payne Rd
Woodstock, GA 30188-1636
Phone
(404) 921-4366
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN253492 GA Primary

Addresses

Primary practice location

502 Payne Rd
Woodstock, GA 30188-1636

Mailing address

502 Payne Rd
Woodstock, GA 30188-1636
Phone (404) 921-4366

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
I20260608000257 GA Practitioner - Nurse Practitioner 3476049412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

207 Crestmont Way
Canton, GA 30114-8875

502 Payne Rd
Woodstock, GA 30188-1636

681 Ashley Forest Dr NW
Acworth, GA 30102-6378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN253492GAMDFamily Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1235929969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PAYNE RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301881636",
            "telephone_number": "404-921-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 PAYNE RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301881636",
            "telephone_number": "404-921-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBURU",
        "first_name": "AMARTHA",
        "middle_name": "EZINNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN253492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.