Individual provider Active NPI

Sefiatu Abu, PMHNP-BC

  • Psychiatry Physician
  • Fayetteville, GA
National Provider Identifier
1982391629
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
RN253363 Issued in GA
Practice address
110 W Pier Way # a
Fayetteville, GA 30214-4617
Phone
(908) 906-0931
NPI assigned
Apr 21, 2023
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X RN253363 GA Primary

Addresses

Primary practice location

110 W Pier Way # a
Fayetteville, GA 30214-4617

Mailing address

223 Medical Center Dr
Riverdale, GA 30274-2640
Phone (770) 991-8500

Other practice location 1

223 Medical Center Dr
Riverdale, GA 30274-2640
Phone (770) 991-8500

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
I20230830003996 GA Practitioner - Nurse Practitioner 4789047242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 Piedmont Ave SE
3Rd Floor
Atlanta, GA 30303-3050
Phone (404) 616-2215

2805 Metropolitan Pkwy SW
Atlanta, GA 30315-7915
Phone (404) 616-1000

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN253363GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Community Health Psychiatry CurrentSince Jul 22, 2023 Accepting new patients

Locations

2180 Satellite Blvd
Ste 400
Duluth, GA 30097
Phone (770) 256-3765

10700 Medlock Bridge Rd
Ste 104
Johns Creek, GA 30097
Phone (770) 476-9885

223 Medical Center Dr
Riverdale, GA 30274
Phone (770) 692-3554

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": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1982391629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MEDICAL CENTER DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742640",
            "telephone_number": "770-991-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W PIER WAY # A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144617",
            "telephone_number": "908-906-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742640",
            "country_code": "US",
            "telephone_number": "770-991-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABU",
        "first_name": "SEFIATU",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "RN253363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.