Individual provider Active NPI

Judith Namakula, N.P-C

  • Family Nurse Practitioner
  • Duluth, GA
National Provider Identifier
1932467768
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN196422 Issued in GA
Practice address
3350 Steve Reynolds Blvd
Duluth, GA 30096
Phone
(706) 666-6196
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 RN196422 GA Primary

Addresses

Primary practice location

3350 Steve Reynolds Blvd
Duluth, GA 30096

Mailing address

3350 Steve Reynolds Blvd
Suite 408
Duluth, GA 30096
Phone (770) 666-6196

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
I20130305000178 GA Practitioner - Nurse Practitioner 5294980850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3350 Steve Reynolds Blvd
Suite 408
Duluth, GA 30096-4512
Phone (678) 783-4449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Nov 1, 2015 Accepting new patients
Express Clinic, LLC CurrentSince Jul 5, 2022 Accepting new patients
Atlanta Family Physicians PC PastSince Feb 25, 2018 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients
Atlanta Health Unlimited Past Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

3628 Satellite Blvd
Unit 958236
Duluth, GA 30095

3350 Steve Reynolds Blvd
Ste 408
Duluth, GA 30096
Phone (678) 783-4449

3350 Steve Reynolds Blvd
Duluth, GA 30096
Phone (678) 783-4449

976 Killian Hill Rd SW
#A
Lilburn, GA 30047
Phone (770) 923-6400

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1932467768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 STEVE REYNOLDS BLVD",
            "address_2": "SUITE 408",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-666-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 STEVE REYNOLDS BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "706-666-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMAKULA",
        "first_name": "JUDITH",
        "credential": "N.P-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-06-01",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN196422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.