Individual provider Active NPI

Mona K Abukhaled, CPNP-PC

  • Pediatric Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1740571561
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1115 Issued in HI
Practice address
2416 Capstone CT
Columbus, GA 31909-2795
Phone
(706) 327-1281
Fax
(706) 576-9714
NPI assigned
Apr 27, 2011
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN-1115 HI
Pediatric Nurse Practitioner 363LP0200X 1115 HI Primary

Addresses

Primary practice location

2416 Capstone CT
Columbus, GA 31909-2795

Mailing address

5538 Roaring Branch Rd
Columbus, GA 31904-2830

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
1115HIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rivertown Pediatrics, P.C. CurrentSince Jul 21, 2024 Accepting new patients

Locations

2416 Capstone Ct
Columbus, GA 31909
Phone (706) 327-1281

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1740571561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5538 ROARING BRANCH RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 CAPSTONE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092795",
            "telephone_number": "706-327-1281",
            "fax_number": "706-576-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUKHALED",
        "first_name": "MONA",
        "middle_name": "K",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "HI",
            "license": "APRN-1115",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "HI",
            "license": "1115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.