Anthony Chukwukelue, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · College Park, GA
NPI 1992595524 · NPPES record last updated May 7, 2025
Key facts
- NPI
- 1992595524
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN269134 (GA)
- Practice address
- 5454 Yorktowne Dr
College Park, GA 30349-5317 - Phone
- (612) 475-9271
- NPI assigned
- May 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250619002042 | GA | Practitioner - Nurse Practitioner | 0143731729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN269134 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uhs of Anchor L.P. | Single Specialty | Current | Accepting new patients |
| Uhs of Anchor L.P. | Single Specialty | Current |
Accepting new patients |
Locations
5454 Yorktowne Dr
College Park, GA 30349
Phone (678) 251-3200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | RN269134 | GA | Yes |
Addresses
Primary practice location
5454 Yorktowne Dr
College Park, GA 30349-5317
Mailing address
5454 Yorktowne Dr
College Park, GA 30349-5317
Phone (678) 251-3200
Other providers in College Park, GA
- Euasteria Chaney
- Charity Community Living Arrangement LLC
- Charity Personal Care Home L.L.C.
- Nicole Chavannes
- Christ the King Day Habilitation Services, Inc.
- Citrine Therapy Source
- Cityviewhealthcare
- CJR Special Transportation LLC
- Clayton Pharma LLC
- Coastal Community Senior Living Services LLC
All providers in College Park, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.