Individual provider Active NPI

Cansery Mwangi

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1447983960
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN239177 Issued in GA
Practice address
10 Park Pi NE
Atlanta, GA 30101
Phone
(404) 616-4444
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN239177 GA Primary

Addresses

Primary practice location

10 Park Pi NE
Atlanta, GA 30101

Mailing address

303 Prescott Dr
Acworth, GA 30101-2717

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
I20221026001820 GA Practitioner - Nurse Practitioner 4981070331 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN239177GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation Single Specialty CurrentSince Sep 1, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#26019
Atlanta, GA 30303
Phone (404) 616-2219

Organizations & group practices 2

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1447983960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PRESCOTT DR",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PARK PI NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30101",
            "telephone_number": "404-616-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "CANSERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN239177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.