Individual provider Active NPI

Chinyere Izuchukwu, NP

  • Family Nurse Practitioner
  • Riverdale, GA
National Provider Identifier
1942698022
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AANP F1214038 Issued in GA
Practice address
2815 Carolina RDG
Riverdale, GA 30296-6021
Phone
(770) 907-9382
NPI assigned
Dec 25, 2014
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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 AANP F1214038 GA Primary

Addresses

Primary practice location

2815 Carolina RDG
Riverdale, GA 30296-6021

Mailing address

2815 Carolina RDG
Riverdale, GA 30296-6021
Phone (770) 907-9382

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
I20160504002477 GA Practitioner - Nurse Practitioner 9133428600 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AANP F1214038GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hospitalists Group, LLC Current Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Mar 6, 2018 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Mar 6, 2018 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince Mar 18, 2017 Accepting new patients
Ennoble HC DMV LLC Past Accepting new patients
Wellness Connect Past Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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": "1419465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1942698022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 CAROLINA RDG",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966021",
            "telephone_number": "770-907-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 CAROLINA RDG",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966021",
            "telephone_number": "770-907-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZUCHUKWU",
        "first_name": "CHINYERE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-25",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "AANP  F1214038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.