Paul Agbor Naenge, MSN, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN234959 Issued in GA

Practice address

105 Carnegie PL Ste 103
Fayetteville, GA 30214-5900

Phone

(770) 716-7999

Fax

(770) 716-8444

NPI assigned

Dec 6, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO, KS, GA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment NPD
• Naeli Healthcare LLC

  • Transportation Network Company
  • Acworth, GA
  • NPI 1164160859
  NPD Authorized official
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453

  KS

  Medicare reassignment
• Physician First Health Network

  • Public Health or Welfare Agency
  • Alpharetta, GA
  • NPI 1598558181
  NPD (past)
• Usrc Southeast Sarasota LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sarasota, FL
  • NPI 1275193070
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1972018364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 HAMILTON CT",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL STE 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302145900",
            "telephone_number": "770-716-7999",
            "fax_number": "770-716-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAENGE",
        "first_name": "PAUL",
        "middle_name": "AGBOR",
        "credential": "MSN, APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN234959",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008309",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "95008309",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "APRN11018999",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "2023021736",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "82362",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Mustain
• Mwamba Mwila, MD
• My Health Reassurance P.C.
• Tiffany Myrick, RBT
• Myrtle Davenport Healthcare Services LLC
• Ryan Curtis Napp, D.C.
• Kelly Nastasi
• Lateefah Nation, RD, LD
• National Medical Equipment & Supply Company LLC
• National Vision, Inc.

• Family Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, 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 May 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.