Individual provider Active NPI

Edwin N Njenga, NP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1740507029
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN152026 Issued in GA
Practice address
2738 N Decatur Rd
Decatur, GA 30033-5910
Phone
(404) 508-8058
Fax
(404) 508-8058
NPI assigned
Apr 27, 2010
Last updated
Nov 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN152026 GA Primary
Family Nurse Practitioner 363LF0000X 809428 TX

Addresses

Primary practice location

2738 N Decatur Rd
Decatur, GA 30033-5910

Mailing address

2027 Alcovy Trace Way
Lawrenceville, GA 30045-7943
Phone (972) 302-3351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN152026GAMDFamily Nurse Practitioner
809428TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
R Edward Roybal MD PA PastSince Apr 28, 2008 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1740507029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 ALCOVY TRACE WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457943",
            "telephone_number": "972-302-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2738 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335910",
            "telephone_number": "404-508-8058",
            "fax_number": "404-508-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJENGA",
        "first_name": "EDWIN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152026",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "809428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.