Individual provider Active NPI

Joy Chidinma Ezuma

  • Nurse Practitioner
  • Austell, GA
National Provider Identifier
1932601143
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN211803 Issued in GA
Practice address
2615 E West Connector Ste 106
Austell, GA 30106-6848
Phone
(770) 941-0010
NPI assigned
Mar 3, 2018
Last updated
Mar 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN211803 GA Primary

Addresses

Primary practice location

2615 E West Connector Ste 106
Austell, GA 30106-6848

Mailing address

1459 Bellemeade Farms Rd SW
Marietta, GA 30008-3857
Phone (404) 579-7264

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
I20220112001496 GA Practitioner - Nurse Practitioner 6800288374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1155 Concord Rd SE
Suite 200
Smyrna, GA 30080-4255
Phone (678) 600-5137

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2810 Paces Ferry Rd SE
Suite 156
Atlanta, GA 30339-5700
Phone (470) 750-1301

3617 Roswell Nerd a
Atlanta, GA 30305-1111
Phone (404) 996-0196

3999 Austell Rd
Suite 901
Austell, GA 30106-1160
Phone (770) 809-3032

5749 Wendy Bagwell Pkwy
Hiram, GA 30141-2815
Phone (470) 523-4130

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN211803GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jan 1, 2022 Accepting new patients
Shree Yamuna Maharaniji,PC PastSince Jul 1, 2020 Accepting new patients

Locations

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

Organizations & group practices 2

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": "1520035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1932601143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 BELLEMEADE FARMS RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083857",
            "telephone_number": "404-579-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E WEST CONNECTOR STE 106",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066848",
            "telephone_number": "770-941-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZUMA",
        "first_name": "JOY",
        "middle_name": "CHIDINMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-03",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN211803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.