Etsegenet G. Endale, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12220213 Issued in GA

Practice address

687 Johnson Ferry Rd
Marietta, GA 30068-4628

Phone

(404) 200-8319

NPI assigned

Feb 7, 2023

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

Specialty

Nurse Practitioner

Education

Mercer University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shepherd Center, Inc.Group PAC ID 1052301777, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shepherd Center Long-term care hospital, Atlanta, GA, CCN 112003

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Shepherd Center Inc

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1043311715
  Medicare reassignment Care Compare group NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shepherd Center Inc

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1043311715

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1780380105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301330381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 JOHNSON FERRY RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684628",
            "telephone_number": "404-200-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDALE",
        "first_name": "ETSEGENET",
        "middle_name": "G.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F12220213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Crista Engelson, LMFT
• Engineered Smiles, LLC

• 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 Feb 23, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.