NPIMap

Individual provider Active NPI

Vivienne Nyambura Nduati-Moody, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1801033733
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
340 Boulevard NE
Suite 145
Atlanta, GA 30312-1273
Phone
(404) 584-7306
Fax
(404) 584-7308
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic Inc 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000005 GA Practitioner - Physician Assistant 4688724743 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jun 9, 2018 Accepting new patients
Medcura Health, Inc. CurrentSince Jan 7, 2017 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

Interoperability endpoints

  • Direct secure messaging: vnduatimoody48579@direct.emory.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

340 Boulevard NE
Suite 145
Atlanta, GA 30312-1273

Mailing address

550 Peachtree St NE
Suite 1600
Atlanta, GA 30308-2247
Phone (404) 881-1094

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 13, 2013.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1801033733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "SUITE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082247",
            "telephone_number": "404-881-1094",
            "fax_number": "404-885-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOULEVARD NE",
            "address_2": "SUITE 145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121273",
            "telephone_number": "404-584-7306",
            "fax_number": "404-584-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUATI-MOODY",
        "first_name": "VIVIENNE",
        "middle_name": "NYAMBURA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.