Individual provider Active NPI

Nicole Fobi Nunga, M.D.

  • Hospitalist Physician
  • Gainesville, GA
National Provider Identifier
1457523508
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
61580 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
Fax
(770) 538-7872
NPI assigned
Mar 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 61580 GA Primary
Internal Medicine Physician 207R00000X 001640 GA

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

3949 S Cobb Dr SE
Smyrna, GA 30080-6342
Phone (770) 434-0710

Other practice location 1

3949 S Cobb Dr SE
Smyrna, GA 30080-6342
Phone (770) 434-0710 ext. 2237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241219000150 GA Practitioner - Hospitalist 1850469263 Reassigns benefits to 5 organizations
I20251203004488 OK Practitioner - Internal Medicine 1850469263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Observation Medicine Services of Oklahoma, LLCGroup PAC ID 9931562956, 203 clinicians
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians
Georgia Hospital Medicine Physicians LLCGroup PAC ID 7618459058, 14 clinicians

Practice addresses (Care Compare)

12451 E 100TH St N
Owasso, OK 74055-4600
Phone (918) 274-5000

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-3131

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2101

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

801 W Gordon St
Thomaston, GA 30286-3426
Phone (706) 647-8111

Hospital & facility affiliations

  • Interim Healthcare of Atlanta Inc Home health agency, Atlanta, GA, CCN 117067
  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Upson Regional Medical Center Hospital, Thomaston, GA, CCN 110002
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
001640GAMDInternal Medicine Physician
061584GAMDPediatrics Physician
61580GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Observation Medicine Services of Oklahoma, LLC CurrentSince Sep 7, 2025 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Nov 1, 2024 Accepting new patients
Emory Health Care Past Accepting new patients
Upson County Hospital Inc Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1457523508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-434-0710",
            "fax_number": "770-801-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000",
            "fax_number": "770-538-7872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3949 S Cobb Dr SE",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806342",
            "country_code": "US",
            "telephone_number": "770-434-0710 x2237",
            "fax_number": "770-801-5286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOBI NUNGA",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "61580",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "001640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.