Rose-Mary Mbibong-Mabo, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

POD001234 Issued in GA

Practice address

315 Boulevard NE Ste 532
Atlanta, GA 30312-1266

Phone

(770) 284-1616

NPI assigned

May 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEEDDD/Endpoint/GEEDDD
• FHIR API: https://api.platform.athenahealth.com/24366/brand/1/csg/1/fhir/r4

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.

• Metro Podiatrists LLC

  • Foot & Ankle Surgery Podiatrist
  • Atlanta, GA
  • NPI 1750778932
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1851703078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451371",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311459371",
            "telephone_number": "770-284-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE STE 532",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121266",
            "telephone_number": "770-284-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2892 Mountain Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300843014",
            "country_code": "US",
            "telephone_number": "770-284-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBIBONG-MABO",
        "first_name": "ROSE-MARY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "GA",
            "license": "POD001234",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001234",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "POD001234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Armitte Mbachu, RN
• Florence Mbaegbu-Duru, PHARMACIST
• Sarah A Mbaeyi
• Nkechi Mbaezue
• O'Brian Obinnaya Mbakwe, MD
• Uzoamaka Catherine Mbionwu
• Chinwe Esther Mbisike Chijindu, MD
• MBM Home Care, LLC
• Chisom Justin Mbonu, MD
• Collins Mbonu

• Primary Podiatric Medicine Podiatrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Primary Podiatric Medicine Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.