Caroline Konadu

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN210353 Issued in GA

Practice address

5955 Jimmy Carter Blvd
Norcross, GA 30071-4641

Phone

(770) 559-3555

NPI assigned

Jun 12, 2023

Last updated

Jun 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: grupomedico.carolinekonadu@160619.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Exelon Health Management LLC

  • Clinic/Center
  • Dallas, TX
  • NPI 1124995279
  Medicare reassignment

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1487338471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714641",
            "telephone_number": "770-559-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714641",
            "telephone_number": "770-559-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONADU",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN210353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• King David Community Center of Atlanta, Inc. (Adult Care)
• Ko-Am Gwinnett Medical
• Yeunie Ko
• Dmitri Kodor, PA-C
• Keila Jenae Kolden
• Nicholas Kongoasa, MD, FACOG
• Korean Traditional Acupuncture LLC
• Grace Koucheravy, FNP
• Lidya Indrajaya Kring
• Sonu Kumar

• Family Nurse Practitioner in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.