Nabil Lutfi Muhanna, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

023643 Issued in GA

Practice address

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3854

Phone

(770) 533-7288

Fax

(770) 534-9800

NPI assigned

Dec 7, 2005

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: nabil.muhanna@longstreetclinic.gadirect.net

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.

• Specialty Spine and Pain PC

  • Interventional Pain Medicine Physician
  • Gainesville, GA
  • NPI 1063053171
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1972588416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 VALLEY RD NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011237",
            "telephone_number": "678-206-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013854",
            "telephone_number": "770-533-7288",
            "fax_number": "770-534-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-533-7288",
            "fax_number": "770-534-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 Beverly Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305012034",
            "country_code": "US",
            "telephone_number": "770-533-7288",
            "fax_number": "770-534-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-533-7288",
            "fax_number": "770-534-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUHANNA",
        "first_name": "NABIL",
        "middle_name": "LUTFI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-02-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "GA",
            "license": "023643",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "023643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "558244",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000254812D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01351948",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52053670",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000254812E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole T Moulder, ACNP
• Mountain View Pediatrics
• Trista Mowery
• Myra Terry Muckle
• Muhammad Mufty, MD
• Alexis Ann Mullane
• John William Mullens IV, AGACNP
• James Patrick Mullin, PSY.D.
• Daniel Ashley Mullis, MD
• Rajasekhar Reddy Mulyala, M.D

• Neurological Surgery Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Neurological Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.