Individual provider Active NPI

Evelyn Lema Tankoh, MRN, APRN, AGNP-BC

  • Adult Health Nurse Practitioner
  • Jonesboro, GA
National Provider Identifier
1922600279
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN118032 Issued in GA
Practice address
7130 Mount Zion Blvd Ste 14B
Jonesboro, GA 30236-2566
Phone
(770) 585-2384
Fax
(470) 288-0223
NPI assigned
Nov 11, 2020
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN118032 GA
Gerontology Registered Nurse 163WG0600X RN118032 GA
Adult Health Nurse Practitioner 363LA2200X RN118032 GA Primary

Addresses

Primary practice location

7130 Mount Zion Blvd Ste 14B
Jonesboro, GA 30236-2566

Mailing address

1975 Highway 54 W Ste 205
Peachtree City, GA 30269-4794
Phone (770) 585-2384

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
I20220503000838 GA Practitioner - Nurse Practitioner 6204223613 Reassigns benefits to 2 organizations

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
Institute of Restorative MedicineGroup PAC ID 8123565926, 3 clinicians

Practice addresses (Care Compare)

7130 Mount Zion Blvd
Suite 14B
Jonesboro, GA 30236-2566
Phone (770) 525-2384

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN118032GAMDGerontology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Restorative Medicine CurrentSince Oct 7, 2025 Accepting new patients
Healthcare at Home LLC CurrentSince Apr 26, 2022 Accepting new patients
Gainesville Foot and Ankle Surgery Center, PC PastSince Sep 21, 2025 Accepting new patients

Locations

1380 Milstead Ave NE
Ste B
Conyers, GA 30012
Phone (770) 483-1100

5040 Snapfinger Woods Dr
Ste 104
Decatur, GA 30035
Phone (678) 777-7165

5243 Snapfinger Woods Dr
Ste 104
Decatur, GA 30035
Phone (404) 465-1933

7130 Mount Zion Blvd
Ste 14B
Jonesboro, GA 30236
Phone (770) 525-2384

1975 Highway 54 W
Ste 200B
Peachtree City, GA 30269
Phone (770) 585-2384

1975 Highway 54 W
Ste 200
Peachtree Cty, GA 30269
Phone (404) 768-3668

1975 Highway 54 W
Ste 205
Peachtree Cty, GA 30269
Phone (678) 561-9000

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.

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1922600279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 HIGHWAY 54 W STE 205",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694794",
            "telephone_number": "770-585-2384",
            "fax_number": "470-288-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 MOUNT ZION BLVD STE 14B",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362566",
            "telephone_number": "770-585-2384",
            "fax_number": "470-288-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKOH",
        "first_name": "EVELYN",
        "middle_name": "LEMA",
        "credential": "MRN, APRN, AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN118032",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "GA",
            "license": "RN118032",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN118032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.