Nelliah Mahachi

Key facts

NPI

1487389342

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

RN252549 (GA)

Practice address

320 Pennbrooke Trce
Johns Creek, GA 30097-1879

Phone

(404) 399-9842

NPI assigned

Jul 22, 2022

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Infectious Disease Professionals, LLC Infectious Disease Physician · Cumming, GA · NPI 1174613459
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 22, 2022.

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1487389342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PENNBROOKE TRCE",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971879",
            "telephone_number": "404-399-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PENNBROOKE TRCE",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971879",
            "telephone_number": "404-399-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHACHI",
        "first_name": "NELLIAH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN252549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Johns Creek, GA · Family Nurse Practitioner in Georgia