Individual provider Active NPI

Necha Shani Matthews

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1710460605
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN209161 Issued in GA
Practice address
4229 Snapfinger Woods Dr
Decatur, GA 30035-3440
Phone
(404) 286-9252
Fax
(404) 286-9253
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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 RN209161 GA Primary

Addresses

Primary practice location

4229 Snapfinger Woods Dr
Decatur, GA 30035-3440

Mailing address

4229 Snapfinger Woods Dr
Decatur, GA 30035-3440
Phone (404) 286-9252

Other identifiers 1

IdentifierTypeStateIssuer
1053769273MedicaidGA

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
I20200605001091 GA Practitioner - Nurse Practitioner 7012338635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

108 N Park Dr
Fayetteville, GA 30214-1645
Phone (770) 487-7807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN209161GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Consultants of Atlanta, Inc. CurrentSince Mar 31, 2020 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Jan 22, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Jan 22, 2024 Accepting new patients
Recovery Consultants of Atlanta, Inc. CurrentSince Mar 31, 2020 Accepting new patients

Locations

4229 Snapfinger Woods Dr
Decatur, GA 30035
Phone (404) 286-9252

3423 Covington Dr
Ste B
Decatur, GA 30032
Phone (404) 284-6061

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

108 N Park Dr
Fayetteville, GA 30214
Phone (770) 461-3466

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEGGAD

Organizations & group practices 4

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": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1710460605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 SNAPFINGER WOODS DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300353440",
            "telephone_number": "404-286-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 SNAPFINGER WOODS DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300353440",
            "telephone_number": "404-286-9252",
            "fax_number": "404-286-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "NECHA",
        "middle_name": "SHANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN209161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053769273",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.