JAIBA PAUL MATHEW AGACNP-BC NPI 1669090460

NPI Information

NPI: 1669090460
Provider Name: JAIBA PAUL MATHEW, AGACNP-BC
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
980 JOHNSON FY RD NE
ATLANTA, GA
ZIP 30342
Phone: (404) 252-0256
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Jaiba Paul Mathew, AGACNP-BC is an acute care nurse practitioner in Atlanta, GA. Jaiba Paul Mathew, AGACNP-BC NPI is 1669090460. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

980 JOHNSON FY RD NE
ATLANTA, GA
ZIP 30342-626
Phone: (404) 252-0256
Fax: (404) 252-0256

The NPI 1669090460 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2020 and was last updated on 7/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	RN207189	GEORGIA	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	RN207189	GEORGIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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