MS. DOROTHY DEE AGYEPONG (CPNP) – Pediatric Nurse Practitioner, NPI 1821214909
Pediatric Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. DOROTHY DEE AGYEPONG (CPNP)
2000 10TH AVE
SUITE 400
COLUMBUS, GA 319013700
Phone: (706) 660-2932
Fax: (706) 660-2935
Type: Location
PO BOX 1038
COLUMBUS, GA 319021038
Phone: (706) 660-6410
Fax: (706) 660-2847
Type: Mailing
3007 2ND ST SE
MOULTRIE, GA 317686798
Phone: (229) 985-1293
Type: Location
2000 10th Ave
Suite 400
Columbus, GA 319013700
Phone: (706) 660-2932
Fax: (706) 660-2935
Type: Location
PO BOX 2650
TIFTON, GA 317932650
Phone: (229) 353-3422
Type: Mailing
39 KENT RD STE 5
TIFTON, GA 317941697
Phone: (229) 353-7337
Fax: (229) 391-4051
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $79.
Total Amount is formed as General ($79) + Research ($0) + Ownership ($0) = $79.
Last reported payment date: 2024-04-10 • Largest payer in this snapshot: Corium, LLC ($43).
Total Amount
$79
General + Research + Ownership
Payments
4
Total payment records
General Amount
$79
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $43 |
| Merck Sharp & Dohme LLC | $20 |
| PFIZER INC. | $16 |
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: 2016-02-24
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 |
|---|---|---|---|---|
| I20160224001710 | 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 31901)
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