Individual provider Active NPI

Heinrich Von Ewegen, FNP-BC

  • Family Nurse Practitioner
  • Rome, GA
National Provider Identifier
1891369021
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN146338 Issued in GA
Practice address
330 Turner McCall Blvd SW Ste 101
Rome, GA 30165-5631
Phone
(706) 291-2745
NPI assigned
May 12, 2021
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN146338 GA Primary

Addresses

Primary practice location

330 Turner McCall Blvd SW Ste 101
Rome, GA 30165-5631

Mailing address

330 Turner McCall Blvd SW Ste 101
Rome, GA 30165-5631

Other practice location 1

495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221104001671 GA Practitioner - Nurse Practitioner 8325448996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

330 Turner McCall SW Blvd
Suite 101
Rome, GA 30165-5631
Phone (706) 291-2745

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN146338GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Jun 1, 2024 Accepting new patients
Floyd Healthcare Management Inc Family CurrentSince Jun 1, 2024 Accepting new patients
Theoria Medical Past Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

330 Turner McCall Blvd SW
Ste 101
Rome, GA 30165
Phone (706) 291-2745

Networks

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

Interoperability endpoints

  • Direct secure messaging: hvonewegen2905765@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1891369021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 TURNER MCCALL BLVD SW STE 101",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 TURNER MCCALL BLVD SW STE 101",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655631",
            "telephone_number": "706-291-2745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Charles Hardy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301575723",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON EWEGEN",
        "first_name": "HEINRICH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN146338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.