Paulette Decontee Kpannah, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN262125 Issued in GA

Practice address

905 Saddle HL
Marietta, GA 30068-4915

Phone

(678) 523-3663

NPI assigned

Nov 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Nurse Practitioner

Practice roles

Locations

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.

• Pure Health Medicine LLC

  • Family Nurse Practitioner
  • Marietta, GA
  • NPI 1548833452
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1740882877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SADDLE HL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684915",
            "telephone_number": "678-523-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SADDLE HL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684915",
            "telephone_number": "678-523-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KPANNAH",
        "first_name": "PAULETTE",
        "middle_name": "DECONTEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN262125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Kotowski
• Marianna Libkind Kovitch, DMD
• Philip F. Kowalske, D.C.
• Philip Kozhikattu
• Kimberly Ann Kozloski, DMD
• Christopher Hugh Kragor, MD DMD
• George A Kramer, M.D.
• Megan Kraner, LCSW
• Krantz Chiropractic Clinic
• Andrew Henry Krantz, D.C.

• Family Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.