Yves-Aime Amougou Amougou, PMHNP-BC, FNP-C
Individual provider Active NPI Nurse Practitioner · Sandy Springs, GA
NPI 1750831954 · NPPES record last updated Apr 14, 2022
Key facts
- NPI
- 1750831954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN-212975 (GA)
- Practice address
- Kaiser Permanente Behavioral Health
1100 Lake Hearn Drive
Sandy Springs, GA 30342 - Phone
- (404) 365-0966
- NPI assigned
- Oct 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Southeast Permanente Medical Group
Practice addresses (Care Compare)
3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171004002201 | GA | Practitioner - Nurse Practitioner | 6204101017 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212975 | GA | MD | Nurse Practitioner |
| APRN-212975 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aime Psychiatric PLLC | Current | Accepting new patients | |
| Uhs of Laurel Heights, LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 212975 | GA | |
| Nurse Practitioner | 363L00000X | APRN-212975 | GA | Yes |
Addresses
Primary practice location
Kaiser Permanente Behavioral Health
1100 Lake Hearn Drive
Sandy Springs, GA 30342
Mailing address
175 Dublin Way
Dallas, GA 30132
Phone (678) 523-7607
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003194359A | Medicaid | GA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Sandy Springs, GA
- Alpha Home Care LLC
- Adesuwa Amadasun
- Ambitious Caregivers Home Care LLC
- American Current Care PA
- American Professional Associates, LLC
- Mary Brett Anderson
- Natarche Anderson
- Ronald Anderson
- Renee Anglin
- Gerald Antoine
All providers in Sandy Springs, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.