Rennie Juanillo Abraham, FNP, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN204958 Issued in GA

Practice address

275 Collier Rd NW
Suite 290
Atlanta, GA 30309-1709

Phone

(404) 352-3300

NPI assigned

Dec 3, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rabraham@psma.gwaydirect.com

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.

• Pulmonary & Sleep Medicine Associates, LLP

  • Specialist
  • Stockbridge, GA
  • NPI 1720009244
  Medicare reassignment NPD

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

{
    "created_epoch": "1322870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1669740783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709",
            "telephone_number": "404-352-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709",
            "telephone_number": "404-352-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "RENNIE",
        "middle_name": "JUANILLO",
        "name_prefix": "Mr.",
        "credential": "FNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-03",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN204958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003139537A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Abraham, DPT
• Bisrat Kidane Abraham, MD
• Jacob Abraham, MD
• Janice Varkey Abraham, CAA
• Justin Abraham, OD
• Yohannes Medhanie Abraham
• Howard Abrahams, DDS
• Jasmine Ayanna Rachelle Abram, MD
• Shakira Danielle Abram, PHARMD
• Shelly Abramowicz, DMD, MPH

• Family Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, 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 11, 2014; 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.