Individual provider Active NPI

Ngozi Doreen Nwaise

  • Nurse Practitioner
  • Grayson, GA
National Provider Identifier
1649622952
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN188872 Issued in GA
Practice address
780 McConnell Run Xing
Grayson, GA 30017-7804
Phone
(678) 467-6010
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN188872 GA Primary

Addresses

Primary practice location

780 McConnell Run Xing
Grayson, GA 30017-7804

Mailing address

780 McConnell Run Xing
Grayson, GA 30017-7804
Phone (678) 467-6010

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
I20161130002035 GA Practitioner - Nurse Practitioner 4486934882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Sep 24, 2016 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 24, 2016 Accepting new patients
Emory Medical Care Foundation CurrentSince Sep 1, 2021 Accepting new patients
Emory Medical Care Foundation Inc Nurse Practitioner Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 1, 2021 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1649622952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 MCCONNELL RUN XING",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177804",
            "telephone_number": "678-467-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 MCCONNELL RUN XING",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177804",
            "telephone_number": "678-467-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAISE",
        "first_name": "NGOZI",
        "middle_name": "DOREEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN188872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, GA

Sources for this page

Verify at the official NPI Registry.