Individual provider Active NPI

Damaris Nyanchama Ondieki, FNP-C

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1477048767
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN247719 Issued in GA
Practice address
654 1St St
Macon, GA 31201-2851
Phone
(478) 738-9443
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN247719 GA Primary

Addresses

Primary practice location

654 1St St
Macon, GA 31201-2851

Mailing address

PO Box 33711
Decatur, GA 30033-0711
Phone (478) 738-9443

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
I20181023000822 GA Practitioner - Nurse Practitioner 1355694241 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2020 Accepting new patients
Georgia Heart Physicians LLC CurrentSince Aug 21, 2018 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2020 Accepting new patients
Macon Electrophysiology Associates PastSince Aug 21, 2018 Accepting new patients

Locations

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

654 1st St
Macon, GA 31201
Phone (478) 738-9443

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHAAAA

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.

Hospital & facility affiliations 1

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1477048767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33711",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300330711",
            "telephone_number": "478-738-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012851",
            "telephone_number": "478-738-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDIEKI",
        "first_name": "DAMARIS",
        "middle_name": "NYANCHAMA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN247719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.