Enoma Evbuomwan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007457 Issued in GA

Practice address

1400 Veterans Memorial Hwy SE # 563
Mableton, GA 30126-2945

Phone

(470) 600-8494

NPI assigned

Feb 11, 2015

Last updated

Mar 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group NPD
• Thelwell Immediate Care Clinic Inc

  • Urgent Care Clinic/Center
  • Mableton, GA
  • NPI 1083256804

  Medical

  NPD Authorized official
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment
• First Class Healthcare LLC

  • Health Maintenance Organization
  • Lawrenceville, GA
  • NPI 1639891765
  NPD (past)

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1578954640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 WOODRUFF RD STE 4",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046096",
            "telephone_number": "470-600-8494",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VETERANS MEMORIAL HWY SE # 563",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262945",
            "telephone_number": "470-600-8494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Nathan Dean Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301574911",
            "country_code": "US",
            "telephone_number": "470-624-6792",
            "fax_number": "470-202-1026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVBUOMWAN",
        "first_name": "ENOMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007457",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elegant and Gentle Hands Home Care (Dba)
• Elite Home Care
• Enrich Psychotherapy
• Brittany ENT
• Euni Lab Mobile Phlebotomy LLC
• Crystal Chantel Everett, PT, DPT
• Family Affair Home Services LLC
• Heather Farling
• Caroline Bailey Fawcett
• Sabrina M Fincher, PHARMD

• Physician Assistant in Mableton, GA
• Providers in Mableton, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• 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.