Aniekeme Odudu Edet

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04220138 Issued in GA

Practice address

5370 Laurel Springs Pkwy
Suwanee, GA 30024-6027

Phone

(678) 760-5292

NPI assigned

Jul 20, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment Care Compare group NPD
• Primary Care PLLC

  • Family Nurse Practitioner
  • Spring, TX
  • NPI 1770354763

  GA

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1922733211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5370 LAUREL SPRINGS PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246027",
            "telephone_number": "678-760-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5370 LAUREL SPRINGS PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246027",
            "telephone_number": "678-760-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDET",
        "first_name": "ANIEKEME",
        "middle_name": "ODUDU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F04220138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "RN283131",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aniekemeedet@protonmail.com",
            "affiliation": "N",
            "address_1": "205 Pebblefield Trce",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300455099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dynasty Health Solutions, Inc
• E. Earl Pennington, MD, LLC
• Zachary Eatough
• Kathleen Ebersol
• Echo Behavioral Health LLC
• Tennisha Edwards, DNP, CPNP-PC
• Walter Carl Ehrenfeuchter, DO
• Jonathan Eidman, DPT
• Sarah Anne Eilert
• Christina Renee Ekstrom

• Family Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.