Individual provider Active NPI

Manisha Asiz Ruhani, NP

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1710334495
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN223779 Issued in GA
Practice address
2990 Five Forks Trickum Rd
Lawrenceville, GA 30044-5872
Phone
(404) 948-3019
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN223779 GA Primary

Addresses

Primary practice location

2990 Five Forks Trickum Rd
Lawrenceville, GA 30044-5872

Mailing address

4895 Post Rd
Cumming, GA 30040
Phone (866) 389-2727

Other practice location 1

4895 Post Rd
Cumming, GA 30040-4978
Phone (866) 389-2727

Other practice location 2

11705 Jones Bridge Rd
A201
Johns Creek, GA 30005-5078
Phone (770) 772-1830

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
I20170118000555 GA Practitioner - Nurse Practitioner 1153603659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

2990 Five Forks Trickum Rd
Lawrenceville, GA 30044-5872
Phone (678) 732-1517

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergent Testing LLC CurrentSince Mar 1, 2022 Accepting new patients
Piedmont Professional Services, LLC CurrentSince Aug 23, 2023 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

13 Corporate Blvd NE
Ste 250
Brookhaven, GA 30329
Phone (229) 442-7210

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

2990 Five Forks Trickum Rd
Lawrenceville, GA 30044
Phone (678) 732-1517

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1710334495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 POST RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 FIVE FORKS TRICKUM RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445872",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4895 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300404978",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11705 Jones Bridge Rd",
            "address_2": "A201",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300055078",
            "country_code": "US",
            "telephone_number": "770-772-1830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUHANI",
        "first_name": "MANISHA",
        "middle_name": "ASIZ",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN223779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.