Individual provider Active NPI

Victoria Ifunanya Williams-Ugula

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1316557929
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN200679 Issued in GA
Practice address
2732 Candler Rd
Decatur, GA 30034-1410
Phone
(470) 444-3133
Fax
(470) 276-4051
NPI assigned
Aug 7, 2020
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN200679 GA
Family Nurse Practitioner 363LF0000X RN200679 GA Primary

Addresses

Primary practice location

2732 Candler Rd
Decatur, GA 30034-1410

Mailing address

PO Box 740015
Atlanta, GA 30374-0015
Phone (312) 733-9730

Other practice location 1

3867 Roswell Rd NE Ste 100
Atlanta, GA 30342-4452
Phone (678) 904-5611

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
I20240610000332 GA Practitioner - Nurse Practitioner 8729520465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Georgia PCGroup PAC ID 0345658647, 37 clinicians

Practice addresses (Care Compare)

2732 Candler Rd
Decatur, GA 30034-1410
Phone (470) 444-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN200679GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Georgia PC Nurse Practitioner CurrentSince Oct 28, 2024 Accepting new patients
Capital Healthcare PC CurrentSince Apr 6, 2024 Accepting new patients
Alex E. Rikhter, MD P.C. Current Accepting new patients
Allcare Ga PC Past Accepting new patients

Locations

3867 Roswell Rd NE
Ste 100
Atlanta, GA 30342
Phone (678) 904-5611

2732 Candler Rd
Decatur, GA 30034
Phone (470) 444-3133

1825 Rockbridge Rd
Ste 15B
Stone Mtn, GA 30087
Phone (470) 444-3134

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1316557929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300341410",
            "telephone_number": "470-444-3133",
            "fax_number": "470-276-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3867 Roswell Rd NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303424452",
            "country_code": "US",
            "telephone_number": "678-904-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS-UGULA",
        "first_name": "VICTORIA",
        "middle_name": "IFUNANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN200679",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN200679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.