Individual provider Active NPI

Isaac Ofori Amanfo

  • Psychiatric/Mental Health Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1912634593
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN265613 Issued in GA
Practice address
59 Hospital Rd
Newnan, GA 30263-1209
Phone
(678) 423-4610
Fax
(770) 830-2266
NPI assigned
Aug 4, 2022
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 307838 AZ
Nurse Practitioner 363L00000X 200607 ND
Family Nurse Practitioner 363LF0000X RN265613 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61572854 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN265613 GA Primary

Addresses

Primary practice location

59 Hospital Rd
Newnan, GA 30263-1209

Mailing address

59 Hospital Rd
Newnan, GA 30263-1209
Phone (678) 423-4610

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
I20260306000813 GA Practitioner - Nurse Practitioner 1850873969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

153 Independence Dr
Carrollton, GA 30116-9000
Phone (678) 854-2150

52 Perry St
Newnan, GA 30263-1974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307838AZMDNurse Practitioner
200607NDMDNurse Practitioner
RN265613GAMDFamily Nurse Practitioner
AP61572854WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Center for Behavioral and Developmental Growth CurrentSince Jan 10, 2026 Accepting new patients
Pathways Center for Behavioral and Developmental Growth CurrentSince Jan 10, 2026 Accepting new patients
Caedel Medical Group PastSince Aug 1, 2022 Accepting new patients
Pathways Center for Behavioral and Developmental Growth Past Accepting new patients

Locations

153 Independence Dr
Carrollton, GA 30116
Phone (770) 836-6678

59 Hospital Rd
Newnan, GA 30263
Phone (678) 423-4610

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIHDBA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1912634593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631209",
            "telephone_number": "678-423-4610",
            "fax_number": "770-830-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631209",
            "telephone_number": "678-423-4610",
            "fax_number": "770-830-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFORI AMANFO",
        "first_name": "ISAAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "307838",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "200607",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN265613",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61572854",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN265613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.