Organization Active NPI

Xanbody LLC

  • Health Service Clinic/Center
  • Atlanta, GA
National Provider Identifier
1497548655
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
XANBODY LLC
Doing business as
Xanbody Medical
Practice address
4300 Paces Ferry Rd SE Ste 500
Atlanta, GA 30339-5714
Phone
(678) 390-4149
Fax
(678) 737-1729
NPI assigned
May 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Irene Obiageri Ibenyenwa, NURSE PRACTITIONERSNPI 1023661816
Title
Ceo
Phone
(404) 906-5056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

4300 Paces Ferry Rd SE Ste 500
Atlanta, GA 30339-5714

Mailing address

4300 Paces Ferry Rd SE Ste 500
Atlanta, GA 30339-5714
Phone (678) 390-4149

Other names 1

  • Xanbody Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250701000155 GA Part B Supplier - Clinic/Group Practice 8820501141 Receives reassigned benefits from 1 practitioner
Practice locations: Kennesaw, GA

National Provider Directory

National Provider Directory

Locations

1350 Wooten Lake Rd NW
Ste 204
Kennesaw, GA 30144
Phone (678) 402-1389

1350 Wooten Lake Rd NW
Kennesaw, GA 30144

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1497548655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395714",
            "telephone_number": "678-390-4149",
            "fax_number": "678-737-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395714",
            "telephone_number": "678-390-4149",
            "fax_number": "678-737-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XANBODY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "IBENYENWA",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "OBIAGERI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-906-5056",
        "authorized_official_credential": "NURSE PRACTITIONERS"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Xanbody Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Xanbody Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.