Individual provider Active NPI

Esther Irungu

  • Gerontology Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1619725488
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN249747 Issued in GA
Practice address
3052 Shallowford Rd
Marietta, GA 30062-1252
Phone
(770) 240-0923
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN249747 GA Primary

Addresses

Primary practice location

3052 Shallowford Rd
Marietta, GA 30062-1252

Mailing address

667 Church St,
Marietta, GA 30060-3573

Other practice location 1

793 Sawyer Rd
Marietta, GA 30062-2222
Phone (470) 644-0100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eirungu138547@directwellstar.org

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
I20240709000223 GA Practitioner - Nurse Practitioner 0648715201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1605 Mulkey Rd
Suite B
Austell, GA 30106-6820
Phone (470) 956-3760

3052 Shallowford Rd
Suite 100
Marietta, GA 30062-1252
Phone (770) 240-0923

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN249747GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2024 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

5705 Atlanta Hwy
Alpharetta, GA 30004
Phone (470) 387-1507

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • Direct secure messaging: eirungu138547@directwellstar.org

Organizations & group practices 3

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": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1619725488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 CHURCH ST,",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300603573",
            "fax_number": "470-986-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3052 SHALLOWFORD RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621252",
            "telephone_number": "770-240-0923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "793 Sawyer Rd",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300622222",
            "country_code": "US",
            "telephone_number": "470-644-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRUNGU",
        "first_name": "ESTHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN249747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eirungu138547@directwellstar.org",
            "affiliation": "N",
            "address_1": "3052 Shallowford Rd",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300621252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.