Favor Family Medical Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAVOR FAMILY MEDICAL PRACTICE LLC

Practice address

103 Mountain Brook Dr Ste 100
Canton, GA 30115-9078

Phone

(678) 880-8893

Fax

(678) 880-8589

NPI assigned

May 18, 2020

Organization subpart

No

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

Authorized official

Name

Eunice Momeh, NPNPI 1457724874

Title

Ceo

Phone

(678) 880-8893

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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

• Eunice Momeh, NP-C

  • Family Nurse Practitioner
  • Alpharetta, GA
  • NPI 1457724874
  Medicare reassignment Care Compare group NPD Authorized official
• Ibrahim Aliu Opaleye, M.D.

  • Family Medicine Physician
  • Buford, GA
  • NPI 1720367287
  Medicare reassignment Care Compare group NPD
• Cynthia Moore Brandon, APRN, FNP-BC

  • Nurse Practitioner
  • Canton, GA
  • NPI 1649748096
  Medicare reassignment NPD

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1336762913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN BROOK DR STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159078",
            "telephone_number": "678-880-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MOUNTAIN BROOK DR STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159078",
            "telephone_number": "678-880-8893",
            "fax_number": "678-880-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAVOR FAMILY MEDICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "MOMEH",
        "authorized_official_first_name": "EUNICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-880-8893",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13911414",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "address_1": "103 Mountain Brook Dr Ste 100",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301159078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "address_1": "103 Mountain Brook Dr Ste 100",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301159078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.eunice@favorfamily.org",
            "affiliation": "N",
            "endpointDescription": "organization email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "103 Mountain Brook Dr Ste 100",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301159078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chelsea Marie Farr
• Carly Marie Farrell, LCSW
• Marilynn L Farrow, M.S., E.I.S.
• Fast Surgical Services
• Christopher Rane Faustin, LMSW
• Favor Health Institute
• Jessica Robin Feehan, NP-C
• Vincilia Fernandes
• Andres Fernandez, PT, DPT
• Antonia M Fernandez, MS OTR/L

• Family Medicine Physician in Canton, GA
• Providers in Canton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.