MRS. GRACE NWACHUKWU IBEANUSI (NP) – Family Nurse Practitioner, NPI 1366776924
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MRS. GRACE NWACHUKWU IBEANUSI (NP)
4515 INVESTORS LN
ELLENWOOD, GA 302946417
Phone: (770) 507-0112
Fax: (770) 507-9450
Type: Mailing
195 FAIRVIEW RD
ELLENWOOD, GA 302942722
Phone: (770) 507-0112
Fax: (770) 507-9450
Type: Location
896 HIGHWAY 81 E
MCDONOUGH, GA 302522914
Phone: (678) 732-1520
Type: Location
PO BOX 102038
ATLANTA, GA 303682038
Phone:
Type: Mailing
195 Fairview Rd
Ellenwood, GA 302942722
Phone: (770) 507-0112
Fax: (770) 507-9450
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 44 Open Payments records for all available years, with a total value of $779.
Total Amount is formed as General ($779) + Research ($0) + Ownership ($0) = $779.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Lilly USA, LLC ($255).
Total Amount
$779
General + Research + Ownership
Payments
44
Total payment records
General Amount
$779
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $255 |
| Novo Nordisk Inc | $181 |
| Astellas Pharma US Inc | $61 |
| Exact Sciences Corporation | $35 |
| Amgen Inc. | $32 |
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: 2011-04-20
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 |
|---|---|---|---|---|
| I20110420000334 | 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 30294)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | AL | |
| Internal Medicine | GA |
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