ICARE CLINIC & MEDSPA LLC NPI 1275124166

NPI Information

  • NPI: 1275124166
  • Provider Name: ICARE CLINIC & MEDSPA LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 11D2221381
  • Address: 4580 MEMORIAL DR
    DECATUR, GA
    ZIP 30032
  • Phone: (770) 856-8988

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NPI Details

ICARE CLINIC & MEDSPA LLC is a family nurse practitioner in Decatur, GA. ICARE CLINIC & MEDSPA LLC NPI is 1275124166. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4580 MEMORIAL DR
DECATUR, GA
ZIP 30032-447
Phone: (770) 856-8988

The provider's authorized official is Sikirat Oropo .
The authorized official title is Owner and has the following contact phone number (770) 856-8988.

The CLIA number assigned to this NPI record is 11D2221381 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2021 and was last updated on 2/7/2024.

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
1363LF0000XNurse PractitionerFamilyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003246181AOTHERGEORGIA003246181A
2734119526RMEDICAIDGEORGIA
3G006535258OTHERGEORGIAPTAN

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: 11/21/2025

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