Individual provider Active NPI

Ellen Jeanette Smead, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1588939151
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
APRN-CNM209228 Issued in GA
Practice address
980 Johnson Ferry Rd Ste 660
Atlanta, GA 30342-1608
Phone
(404) 497-1350
Fax
(404) 497-1427
NPI assigned
Mar 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN-CNM209228 GA Primary
Advanced Practice Midwife 367A00000X

Addresses

Primary practice location

980 Johnson Ferry Rd Ste 660
Atlanta, GA 30342-1608

Mailing address

980 Johnson Ferry Rd Ste 660
Atlanta, GA 30342-1608
Phone (404) 497-1350

Other names 1

  • Ellen Dassaboute 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602001709 GA Practitioner - Certified Nurse Midwife (CNM) 8022308071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN-CNM209228GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Womens Group LLC CurrentSince Feb 20, 2026 Accepting new patients

Locations

460 Northside Cherokee Blvd
Ste 360
Canton, GA 30115
Phone (678) 891-6541

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

980 Johnson Ferry Rd
Ste 660
Sandy Springs, GA 30342
Phone (404) 497-1350

Organizations & group practices 2

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1588939151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FERRY RD STE 660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421608",
            "telephone_number": "404-497-1350",
            "fax_number": "404-497-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FERRY RD STE 660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421608",
            "telephone_number": "404-497-1350",
            "fax_number": "404-497-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEAD",
        "first_name": "ELLEN",
        "middle_name": "JEANETTE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "APRN-CNM209228",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "DASSABOUTE",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.