Philip Boadu, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP303104 Issued in GA

Practice address

4763 Atlanta Hwy Ste 420
Loganville, GA 30052-6788

Phone

(404) 395-6781

NPI assigned

Jul 30, 2020

Last updated

Oct 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, GA2 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 2

Specialty

Nurse Practitioner

Education

City University of New York School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD
• Morris Heights Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1184694291
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• Morris Heights Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1104374685
  NPD

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1992314439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 SPRINGLAKE RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465090",
            "telephone_number": "646-226-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4763 ATLANTA HWY STE 420",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300526788",
            "telephone_number": "404-395-6781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Donizetti Pl Apt 18F",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104752069",
            "country_code": "US",
            "telephone_number": "646-226-7209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOADU",
        "first_name": "PHILIP",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP303104",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "651299",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F346860-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenimol Biju, PMHNP-BC
• Kevin F Blair, DDS
• Blake's Mobile Care
• Blessings Medical Staffing LLC
• BMC Helping Hands for You LLC
• Board of Health Walton County (Walton County Health Department Loganville)
• Board of Health Walton County
• Donya Boatwright-Johnson
• Jesty Boby, FNP-C
• Bold Ark LLC

• Family Nurse Practitioner in Loganville, GA
• Providers in Loganville, 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 Oct 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.