Kingsley E Iyamu, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

044493 Issued in GA

Practice address

1850 Lake Park Dr SE
218
Smyrna, GA 30080-7647

Phone

(404) 213-8526

Fax

(770) 438-1125

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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.

• Apex Behavioral Associates, LLC

  • Psychiatry Physician
  • Marietta, GA
  • NPI 1710154893

  GA, Psychiatry

  Medicare reassignment Care Compare group NPD
• Carenow Services, LLC

  • Community/Behavioral Health Agency
  • Roswell, GA
  • NPI 1770713117

  GA

  Medicare reassignment Care Compare group NPD
• McIntosh Trail Community Service Board

  • Community/Behavioral Health Agency
  • Griffin, GA
  • NPI 1336317270

  GA

  Medicare reassignment

Specialty

Psychiatry

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Behavioral Associates, LLC 2 clinicians

Carenow Services, LLC 36 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

49.38 of 100Reported as group

Quality

4.35

Promoting interoperability

0

Improvement activities

40

Cost

76.92

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 19, 2011.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1275615171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 LAKE PARK DR SE",
            "address_2": "218",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807647",
            "telephone_number": "404-213-8526",
            "fax_number": "770-438-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LAKE PARK DR SE",
            "address_2": "218",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807647",
            "telephone_number": "404-213-8526",
            "fax_number": "770-438-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYAMU",
        "first_name": "KINGSLEY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "044493",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "GA",
            "license": "044493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000899808B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Institute for Behavioral Medicine
• Integrity Medical Supply
• Intervention Strategies, LLC
• Isom E White LCSW, LLC
• Masayuki Iwahashi, CCC-SLP
• Gregory C Izenour, PTA
• J & S Healthcare Associates, P.C.
• Gabrielle Jackson
• Jessika Renee Jackson, MD
• Lameka Aja Jackson

• All providers in Smyrna, GA
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.