Individual provider Active NPI

Ngassa Nchapada Menga Faith, NP

  • Family Nurse Practitioner
  • Ellenwood, GA
National Provider Identifier
1265059299
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN237253 Issued in GA
Practice address
2568 Brittany Park CV
Ellenwood, GA 30294-6288
Phone
(404) 578-5437
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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 RN237253 GA Primary

Addresses

Primary practice location

2568 Brittany Park CV
Ellenwood, GA 30294-6288

Mailing address

2568 Brittany Park CV
Ellenwood, GA 30294-6288
Phone (404) 578-5437

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
I20210412000773 GA Practitioner - Nurse Practitioner 4587072566 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN237253GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Minuteclinic LLC Family CurrentSince Sep 1, 2020 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2305 Highway 34 E
Newnan, GA 30265
Phone (678) 423-1043

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

Organizations & group practices 4

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": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1265059299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2568 BRITTANY PARK CV",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946288",
            "telephone_number": "404-578-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2568 BRITTANY PARK CV",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946288",
            "telephone_number": "404-578-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGA FAITH",
        "first_name": "NGASSA",
        "middle_name": "NCHAPADA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.