Jerome Ndikumukiza

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

3938 E Ponce de Leon Ave Ste D
Clarkston, GA 30021-8104

Phone

(404) 964-2147

NPI assigned

Mar 14, 2025

Sex

Male

Sole proprietor

Yes

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.

• Intabwe Community,Inc

  • In Home Supportive Care Agency
  • Clarkston, GA
  • NPI 1912605379
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 14, 2025.

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1881494490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 E PONCE DE LEON AVE STE D",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300218104",
            "telephone_number": "404-964-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 E PONCE DE LEON AVE STE D",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300218104",
            "telephone_number": "404-964-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIKUMUKIZA",
        "first_name": "JEROME",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mela Urgent and Primary Care Clinic LLC
• Hellen Moges
• Moallim Mohamed
• Nazir A. Mousselli, D.C.
• Stephanie Rene Murray, M.A., CD-B/P, D.V.
• Yolanda Nesbitt, RN, BSN, CMGT-BC
• Trung The Nguyen
• Dana Vermelle Nowlin, PHD, LPC
• Nurture Home Care LLC
• Kareem Osborne

• All providers in Clarkston, GA
• Personal Care Attendant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.