Individual provider Active NPI

Achangwo Mary Lekeaka, FNP

  • Family Nurse Practitioner
  • Athens, GA
National Provider Identifier
1568235661
Registry record updated Jun 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN260257 Issued in GA
Practice address
180 Epps Bridge Rd
Athens, GA 30606-3312
Phone
(706) 549-5382
NPI assigned
Nov 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2024

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 RN260257 GA Primary

Addresses

Primary practice location

180 Epps Bridge Rd
Athens, GA 30606-3312

Mailing address

1599 School House Run
Dacula, GA 30019-7805
Phone (706) 308-5012

Other names 1

  • Achangwo Mary Lekeaka Former name

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
I20231127001592 GA Practitioner - Nurse Practitioner 2365890712 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN260257GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nicely Health Services LLC CurrentSince Nov 5, 2023 Accepting new patients
Gracewell Health and Wellness Clinic Family CurrentSince Feb 3, 2026 Accepting new patients
Georgia Mso LLC CurrentSince Apr 15, 2025 Accepting new patients
Hardy Renew Wellness,LLC CurrentSince Nov 1, 2023 Accepting new patients
North Georgia Neprology Consultants LLC CurrentSince May 1, 2025 Accepting new patients

Locations

5105 Jefferson Rd
#B
Athens, GA 30607
Phone (706) 227-4075

5105 Jefferson Rd
#A
Athens, GA 30607
Phone (706) 549-6885

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

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.

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1568235661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 SCHOOL HOUSE RUN",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197805",
            "telephone_number": "706-308-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 EPPS BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063312",
            "telephone_number": "706-549-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEKEAKA",
        "first_name": "ACHANGWO",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ACHANGWO",
            "last_name": "LEKEAKA",
            "middle_name": "MARY",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.