MRS. NGOZI DOREEN NWAISE – Nurse Practitioner, NPI 1649622952

MRS. NGOZI DOREEN NWAISE is a healthcare provider. based in Grayson, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN188872 (GA). The NPI Number for MRS. NGOZI DOREEN NWAISE is 1649622952

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
MRS. NGOZI DOREEN NWAISE
NPI
1649622952
Phone
(678) 467-6010
Address
780 MCCONNELL RUN XING
Enumeration Date
11 July 2016
Last Update Date
11 July 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4046161000
Graduation Year
2014 (12 years ago)
PAC ID
4486934882
Group Practice PAC ID
4981501814
Professional Enrollment ID
I20161130002035
Address ID
GA303033031AT80XXXSEXX600
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MRS. NGOZI DOREEN NWAISE

  • 780 MCCONNELL RUN XING

    GRAYSON, GA 300177804

    Phone: (678) 467-6010

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-11-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161130002035INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making7238$0
View full utilization report →

Insurance plans in this area (ZIP 30017)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981501814View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineCA
Interventional Radiology, Diagnostic RadiologyKY
A N E S T H E S I O L O G YGA
Gastroenterology, Internal MedicineGA
-GA
Oral Surgery, Maxillofacial SurgeryGA
Cardiovascular Disease (Cardiology), Internal MedicineGA
P S Y C H I A T R YGA
Physician AssistantGA
Internal Medicine, Infectious DiseaseGA

Reviews

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Frequently asked questions

Is MRS. NGOZI DOREEN NWAISE listed with a National Provider Identifier?
Yes — MRS. NGOZI DOREEN NWAISE has NPI 1649622952 on file in the registry.
Is MRS. NGOZI DOREEN NWAISE still an active registrant?
MRS. NGOZI DOREEN NWAISE carries an active NPI according to the public dataset.
What area of care is associated with MRS. NGOZI DOREEN NWAISE?
MRS. NGOZI DOREEN NWAISE's record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MRS. NGOZI DOREEN NWAISE located near Grayson?
MRS. NGOZI DOREEN NWAISE currently maps to Grayson, Georgia in this extract.
Can I trust this NPI listing for MRS. NGOZI DOREEN NWAISE?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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