Maggie L Gofan-Yleah, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F07210811 Issued in GA

Practice address

2612 Legacy Walk CT
Grayson, GA 30017-7833

Phone

(678) 637-1247

NPI assigned

May 1, 2022

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment

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

{
    "created_epoch": "1651363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651363200000",
    "number": "1700521093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 LEGACY WALK CT",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177833",
            "telephone_number": "678-637-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 LEGACY WALK CT",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177833",
            "telephone_number": "678-637-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFAN-YLEAH",
        "first_name": "MAGGIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-01",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F07210811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gcat EMS LLC
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• Beatrice Lea Gibson, MT
• Grace Pediatric Dental Care LLC
• Simone Althea Graham-Murray, NP
• Shalaya Gray
• Grayson Dental Associates, LLC
• Grayson Pediatric Dentistry, P.C.

• Family Nurse Practitioner in Grayson, GA
• Providers in Grayson, 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 May 1, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.