Individual provider Active NPI

Lilian Chinyere Eneude

  • Psychiatric/Mental Health Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1730871120
Registry record updated May 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN194074 Issued in GA
Practice address
445 Winn Way FL 2
Decatur, GA 30030-1707
Phone
(404) 508-7700
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN194074 GA Primary

Addresses

Primary practice location

445 Winn Way FL 2
Decatur, GA 30030-1707

Mailing address

445 Winn Way FL 2
Decatur, GA 30030-1707

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
I20230628000587 GA Practitioner - Nurse Practitioner 7315305059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN194074GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Community Service Board Single Specialty CurrentSince May 22, 2023 Accepting new patients
Dekalb Community Service Board PastSince May 22, 2023 Accepting new patients

Locations

455 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

445 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

445 Winn Way
Fl 2
Decatur, GA 30030
Phone (404) 294-3836

Organizations & group practices 2

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685232000000",
    "number": "1730871120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINN WAY FL 2",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY FL 2",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-508-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENEUDE",
        "first_name": "LILIAN",
        "middle_name": "CHINYERE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-28",
        "certification_date": "2023-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN194074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.