Organization Active NPI

Absolute Health Family & Urgent Care Clinic

  • Family Nurse Practitioner
  • Riverdale, GA
National Provider Identifier
1851894588
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN201832 Issued in GA
Legal business name
ABSOLUTE HEALTH FAMILY & URGENT CARE CLINIC
Practice address
7574 Ga 85
Riverdale, GA 30274
Phone
(000) 000-0000
Fax
(404) 393-7144
NPI assigned
Mar 8, 2018
Last updated
Jun 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Authorized official

Name
Ernest Amukamara, FNPNPI 1356529101
Title
President
Phone
(678) 232-3191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X RN201832 GA
Family Nurse Practitioner 363LF0000X RN201832 GA Primary

Addresses

Primary practice location

7574 Ga 85
Riverdale, GA 30274

Mailing address

7574 Ga 85
Riverdale, GA 30274-3447

Other identifiers 2

IdentifierTypeStateIssuer
1356529101OtherGANPI
817526188GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180606002895 GA Part B Supplier - Clinic/Group Practice 3779848072 Receives reassigned benefits from 1 practitioner
Practice locations: Riverdale, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2149541Absolute Health Family and Urgent Care Clinic, LLC7574 Ga - 85, Riverdale, GA 30274Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1851894588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7574 GA 85",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302743447",
            "fax_number": "404-393-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7574 GA 85",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "000-000-0000",
            "fax_number": "404-393-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUTE HEALTH FAMILY & URGENT CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "AMUKAMARA",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-232-3191",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "RN201832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN201832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356529101",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "817526188G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.