Icare Clinic & Medspa LLC | NPI 1275124166

Key facts

NPI: 1275124166
Entity type: Organization (NPI type 2)
Primary specialty: Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name: ICARE CLINIC & MEDSPA LLC
Practice address: 4580 Memorial Dr
Decatur, GA 30032-1447
Phone: (770) 856-8988
NPI assigned: Feb 2, 2021
Organization subpart: No

Authorized official

Name: Sikirat Oropo, DNP NPI 1780662775
Title: Owner
Phone: (770) 856-8988

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Sikirat Yetunde Oropo, MSN, DNP Family Nurse Practitioner · Decatur, GA · NPI 1780662775

Medicare reassignment NPD Authorized official FAMILY · GA
Elizabeth M Acloque, FNP-BC Family Nurse Practitioner · Palm Coast, FL · NPI 1972191005

Medicare reassignment NPD FAMILY · GA
Gabriella Chase Williams, ARNP Gerontology Nurse Practitioner · Decatur, GA · NPI 1952130635

NPD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
11D2221381	Icare Clinic & Medspa, LLC 4580 Memorial Drive, Decatur, GA 30032	Certificate of waiver	Apr 20, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20210902003068	GA	Part B Supplier - Clinic/Group Practice	1658777412	Receives reassigned benefits from 2 practitioners Practice locations: Decatur, GA

National Provider Directory

Locations

4580 Memorial Dr
Decatur, GA 30032
Phone (404) 963-6861

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner Group: 193200000X MULTI-SPECIALTY GROUP	363LF0000X
Psychiatric/Mental Health Nurse Practitioner Group: 193200000X MULTI-SPECIALTY GROUP	363LP0808X			Yes

Addresses

Primary practice location

4580 Memorial Dr
Decatur, GA 30032-1447

Mailing address

4580 Memorial Dr
Decatur, GA 30032-1447
Phone (404) 963-6861

Other identifiers

Identifier	Type	State	Issuer
003246181A	Other	GA	003246181A
734119526R	Medicaid	GA
G006535258	Other	GA	PTAN

Other providers in Decatur, GA

Michael Francis Iademarco, M.D.
Ian Katz MD
Joy Nkiruka Ibeh
John Chinaka Ibemere, LPN
Musibau A Ibraheem, MD
Icare Healthcare LLC
Icfmr at Georgia Regional Hospital Atlanta
Ida'S Cove
Ideal Dental Decatur PC
Faith Ighile, FNP-C

All providers in Decatur, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.