Active NPI
Naomi Naganoma, PA-C
- Medical Physician Assistant
- Cumming, GA
National Provider Identifier
1497588693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 12593
- Practice address
- 2870 Ronald Reagan Blvd Ste 200
Cumming, GA 30041-6092 - Phone
- (404) 994-4561
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 12593 | GA | |
| Medical Physician Assistant | 363AM0700X | 12593 | GA | Primary |
Addresses
Primary practice location
2870 Ronald Reagan Blvd Ste 200
Cumming, GA 30041-6092
Mailing address
2870 Ronald Reagan Blvd Ste 200
Cumming, GA 30041-6092
Phone (404) 994-4561
Other practice location 1
1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2011
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12593 | GA | MD | Medical Physician Assistant |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JGAACA/Endpoint/JGAACA
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.
-
- Cardiovascular Disease Physician
- Cumming, GA
- NPI 1306139449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1497588693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2870 RONALD REAGAN BLVD STE 200",
"city": "CUMMING",
"state": "GA",
"postal_code": "300416092",
"telephone_number": "404-994-4561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2870 RONALD REAGAN BLVD STE 200",
"city": "CUMMING",
"state": "GA",
"postal_code": "300416092",
"telephone_number": "404-994-4561"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Center Blvd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271570001",
"country_code": "US",
"telephone_number": "336-716-2011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAGANOMA",
"first_name": "NAOMI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "12593",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "12593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.