Individual provider Active NPI

Amma Abunyewa, M.D.

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1982932745
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.094507 Issued in OH
Practice address
4180 Providence Rd Ste 105
Marietta, GA 30062-6187
Phone
(770) 973-4749
NPI assigned
Dec 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.094507 OH Primary

Addresses

Primary practice location

4180 Providence Rd Ste 105
Marietta, GA 30062-6187

Mailing address

4180 Providence Rd Ste 105
Marietta, GA 30062-6187
Phone (770) 973-4749

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000330 GA Practitioner - Internal Medicine 4688868243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4180 Providence Rd
Suite 105
Marietta, GA 30062-6186

4180 Providence Rd
Suite 105
Marietta, GA 30062-6187
Phone (770) 973-4749

Hospital & facility affiliations

  • Sandy Springs Center for Nursing and Healing LLC Nursing home, Atlanta, GA, CCN 115504
  • Roselane Health Center by Harborview Nursing home, Marietta, GA, CCN 115660
  • Perimeter Rehabilitation Suites by Harborview Nursing home, Atlanta, GA, CCN 115270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.094507OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Rd Primary Care LLC Internal Medicine CurrentSince May 21, 2013 Accepting new patients
Urgent Care Clinics LLC Internal Medicine Current Accepting new patients
Dunwoody Health Center by Harborview, LLC Past Accepting new patients
Roselane Health Center by Harborview, LLC Past Accepting new patients
Sandy Springs Center for Nursing and Healing LLC Past Accepting new patients

Locations

4180 Providence Rd
Ste 105
Marietta, GA 30062
Phone (770) 973-4749

Interoperability endpoints

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

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1259971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1982932745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 PROVIDENCE RD STE 105",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626187",
            "telephone_number": "770-973-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 PROVIDENCE RD STE 105",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626187",
            "telephone_number": "770-973-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUNYEWA",
        "first_name": "AMMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-05",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.094507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.