Individual provider Active NPI

Kofi-Ann McDermott, NP

  • Nurse Practitioner
  • Lithonia, GA
National Provider Identifier
1427821990
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN272681 Issued in GA
Practice address
5700 Hillandale Dr
Lithonia, GA 30058-4103
Phone
(770) 981-5431
Fax
(770) 981-5515
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN272681 GA Primary

Addresses

Primary practice location

5700 Hillandale Dr
Lithonia, GA 30058-4103

Mailing address

1835 Savoy Dr Ste 203
Atlanta, GA 30341-1073
Phone (770) 496-9430

Other practice location 1

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 595-7882

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kofiann.mcdermottfnpc.p1@direct.gacancer.nextgenshare.com Direct

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
I20231120003139 GA Practitioner - Nurse Practitioner 9234587833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSH Cancer Institute Professional Services G LLCGroup PAC ID 0840443164, 115 clinicians

Practice addresses (Care Compare)

5700 Hillandale Dr
Suite 250
Lithonia, GA 30058-4120
Phone (770) 981-5431

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN272681GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G LLC CurrentSince Dec 1, 2023 Accepting new patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Dec 1, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Nov 16, 2024 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients
Northside Imaging LLC Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

1501 Milstead Rd NE
Ste 110
Conyers, GA 30012
Phone (770) 460-9949

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

5700 Hillandale Dr
Ste 250
Lithonia, GA 30058
Phone (770) 981-5431

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: kofiann.mcdermottfnpc.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 5

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1427821990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 203",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411073",
            "telephone_number": "770-496-9430",
            "fax_number": "404-891-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 HILLANDALE DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584103",
            "telephone_number": "770-981-5431",
            "fax_number": "770-981-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 N Decatur Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300335918",
            "country_code": "US",
            "telephone_number": "678-595-7882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "KOFI-ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN272681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kofiann.mcdermottfnpc.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "2701 N Decatur Rd",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300335918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.