Selamawit Mola, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN212894 Issued in GA

Practice address

5468 Memorial Dr Ste D
Stone Mountain, GA 30083-3267

Phone

(404) 963-2142

Fax

(404) 963-2098

NPI assigned

Feb 7, 2023

Last updated

Sep 18, 2024By 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 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DBBHDD/Endpoint/DBBHDD

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.

• Salam Clinic Primary and Urgent Care

  • Primary Care Clinic/Center
  • Stone Mountain, GA
  • NPI 1023845880
  Medicare reassignment NPD Authorized official
• Clarkston Primary & Urgent Care, LLC

  • Family Medicine Physician
  • Clarkston, GA
  • NPI 1043781420
  NPD (past)

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1619673944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5468 MEMORIAL DR STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833267",
            "telephone_number": "404-963-2142",
            "fax_number": "404-963-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5468 MEMORIAL DR STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833267",
            "telephone_number": "404-963-2142",
            "fax_number": "404-963-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLA",
        "first_name": "SELAMAWIT",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN212894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MLK Urgent Care Center
• MMT Care LLC
• Mnodern Ecclesia
• Michael Moccio, D.C.
• Hassan Ali Moeti, DMD
• Lorna Angela Mollison, RN.
• Alisa Monfalcone, LCSW
• Yahima Montecelo
• Latanga Montgomery
• Liliane A Monthe Nchako

• Family Nurse Practitioner in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.

Verify at the official NPI Registry.