ENYANG ETENGENENG (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1306391198
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
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Provider Addresses for ENYANG ETENGENENG (PMHNP)
2926 AUSTIN COMMON DR
DACULA, GA 300192715
Phone: (770) 866-7745
Type: Mailing
Lawrenceville, Gwinnett County, Georgia, United States
LAWRENCEVILLE, GA 300468444
Phone: (678) 209-2394
Type: Location
745 S MILLEDGE AVE STE 1A
ATHENS, GA 306051292
Phone: (706) 498-9560
Fax: (706) 498-9568
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $57.
Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.
Last reported payment date: 2024-07-10 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($44).
Total Amount
$57
General + Research + Ownership
Payments
3
Total payment records
General Amount
$57
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Otsuka America Pharmaceutical, Inc. | $44 |
| Teva Pharmaceuticals USA, Inc. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-04-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250409000739 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30019)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | FL | |
| - | GA | |
| - | GA | |
| Clinical Psychologist | GA | |
| Nurse Practitioner | GA | |
| Clinical Psychologist | GA | |
| Marriage And Family Therapist | GA | |
| P S Y C H I A T R Y | GA | |
| Clinical Psychologist | GA |
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