KEN IBETO (NPI# 1053807347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053807347 |
| Entity Type | Individual |
| Full Name | KEN IBETO |
| Other Name | KENECHUKWU IKECHUKWU IBETO |
| Practice Address |
7646 Forest Glen Way Lithia Springs GA 30122-6867 |
| Practice Telephone | 6786376249 |
| Practice Fax Number | 4043934950 |
| Mailing Telephone | 6786376249 |
| Mailing Fax Number | 4043934950 |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SH0200X |
Clinical Nurse Specialist Specialization: Home Health |
048-R-2014 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7646 FOREST GLEN WAY |
| City | LITHIA SPRINGS |
| State | GA |
| Zip Code | 30122-6867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043798838 | Vivian Adu-aboagye | Registered Nurse | 7603 Forest Glen Way, Lithia Springs, GA 30122 | 2018-08-02 |
| 1588150510 | Vanessa Levet Hayes | Driver | 2100 Mesa Valleyway Apt1507, Lithiasprings, GA 30122 | 2018-07-02 |
| 1699279141 | Ariel Shell | Massage Therapist | 2060 Rolling Rock Ct, Lithia Springs, GA 30122 | 2018-03-20 |
| 1013323872 | First Choice Supportive Services, Incorporated | Personal Emergency Response Attendant | 3423 Summerlin Parkway, Lithia Springs, GA 30122 | 2014-07-01 |
| 1245659275 | Thumbs-up Transportation | Non-emergency Medical Transport (VAN) | 1517 Fenmore St., Lithia Springs, GA 30122 | 2014-04-07 |
| 1205262789 | Diana C Harris | Counselor | 561 Thornton Rd. Unit R, Lithia Springs, GA 30122 | 2013-09-17 |
| 1497910475 | Valissa Ann Dixon | Counselor | 6852 Florence Drive, Lithia Springs, GA 30122 | 2008-07-18 |
| 1548473267 | Lawrence Vision, Inc. | Ophthalmology | 939 Bob Arnold Blvd., Suite G, Lithia Springs, GA 30122 | 2007-05-08 |
| 1790903342 | Nahid Bahrami | Dentist | 524 Thornton Rd., Lithia Springs, GA 30122 | 2007-04-20 |
| 1831231828 | Harley Alan Belinky | Dentist | 1515 Westfork Dr., Lithia Springs, GA 30122 | 2007-02-13 |
| Find all providers in zip 30122 | ||||
| Taxonomy Code | 364SH0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Home Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1447893037 | Epic Home Care Services LLC | Clinical Nurse Specialist | 2060 Jackson Ridge Cv Nw, Kennesaw, GA 30144-3149 | 2019-10-25 |
| 1871928234 | Integrity Home Visits | Clinical Nurse Specialist | 83 Bass Dr Ste D, Richmond Hill, GA 31324 | 2013-09-04 |
| 1942807219 | Harmony Healthcare Services | Clinical Nurse Specialist | 100 Hartsfield Center Pkwy Ste 500, Atlanta, GA 30354-1377 | 2020-10-08 |
| City | LITHIA SPRINGS |
| Zip Code | 30122 |
Please comment or provide details below to improve the information on KEN IBETO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.