1. Home
  2. Directory
  3. Georgia
  4. Roswell
  5. Family Medicine
  6. NPI Profile

ICECARE LLC
NPI 1366202236
Family Medicine in Roswell, GA

Active since March 19, 2024CLIA 11D2305935 · Waiver
976 MANSELL RD, ROSWELL, GA 30076(770) 800-3277(770) 800-3537 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Icecare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICECARE LLC (NPI 1366202236), doing business as Vitalcare Express, is a healthcare organization registered as a family medicine in Roswell, Georgia and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through June 9, 2028 and lists Anthony Chukwuemeka C Iwelunmor, Md, as its authorized official.

NPPES Registry Identity

NPI1366202236
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameICECARE LLC
Location Address976 MANSELL RDRoswell, GA 30076-1533
Mailing Address976 Mansell RdRoswell, GA 30076-1533 · (770) 800-3277 · Fax (770) 800-3537
Phone(770) 800-3277
Fax(770) 800-3537
Organization SubpartNo
Authorized OfficialAnthony Chukwuemeka C IwelunmorMd · (770) 800-3277
Enumeration DateMarch 19, 2024
NPPES CertifiedMarch 19, 2024
✔ NPI 1366202236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
976 MANSELL RD, Roswell, GA 30076
Open in Google Maps ↗

Other Names 1

Doing Business AsVitalcare Express

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Icecare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

12

Medicare enrollment records show 12 clinicians reassign Medicare billing to Icecare LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner9
Family Practice1
Nephrology1
Obstetrics/Gynecology1

Clinicians, nearest first (12)

Amanda Iwelunmor, NP
Nurse Practitioner
NPI 1154749356
976 MANSELL RD
Roswell, GA 30076
(770) 800-3277
✔ PECOS✔ Accepts MedicareSame address
Nahideh Pazhouhesh, NP
Nurse Practitioner
NPI 1730990847
5665 PEACHTREE DUNWOODY RD
Sandy Springs, GA 30342
(678) 377-5240
✔ PECOS✔ Accepts Medicare9.3 mi
Carla Penaherrera, FNP
Nurse Practitioner
NPI 1285414722
1000 JOHNSON FY RD NE
Atlanta, GA 30342
(404) 303-3929
✔ PECOS✔ Accepts Medicare9.4 mi
Monica Castro, MSN, FNP-BC
Nurse Practitioner
NPI 1841865557
2924 CLAIRMONT RD NE APT 229
Brookhaven, GA 30329
(504) 756-2513
✔ PECOS✔ Accepts Medicare14 mi
Eberechukwu Azumah, M.D, MPH
Obstetrics/Gynecology
NPI 1194041830
80 JESSE HILL JR DR SE
Atlanta, GA 30303
(734) 730-0329
✔ PECOS✔ Accepts Medicare20 mi
Cindy Liberal, APRN
Nurse Practitioner
NPI 1659922508
1762 MARS HILL RD NW
Acworth, GA 30101
(404) 948-3019
✔ PECOS✔ Accepts Medicare22 mi
Shanay Smith, FNP
Nurse Practitioner
NPI 1316728611
3758 HIGHWAY 42 S
Locust Grove, GA 30248
(678) 561-9430
✔ PECOS✔ Accepts Medicare49 mi
Anita English
Nurse Practitioner
NPI 1124689856
35 HOSPITAL RD
Blairsville, GA 30512
(706) 745-2111
✔ PECOS✔ Accepts Medicare62 mi
Anthony Iluyomade, MD
Nephrology
NPI 1437554250
58 BIG A RD
Toccoa, GA 30577
(706) 886-3148
✔ PECOS✔ Accepts Medicare69 mi
Anthony Iwelunmor
Family Practice
NPI 1033571799
710 CENTER ST
Columbus, GA 31901
(706) 571-1000
✔ PECOS✔ Accepts Medicare114 mi
Ashley Cratic, FNP
Nurse Practitioner
NPI 1861264764
1501 BISCAYNE BLVD
Miami, FL 33132
(877) 870-0323
✔ PECOS✔ Accepts Medicare620 mi
Corinne Anthony-Manswell, NP
Nurse Practitioner
NPI 1538793443
8400 WASHINGTON AVE
Mount Pleasant, WI 53406
(262) 884-4088
✔ PECOS629 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2305935

Icecare, LLC Dba Vitalcare Express · Roswell, GA
Active · expires Jun 9, 2028
CLIA Number11D2305935
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2026
Certificate Expiration DateJune 9, 2028
Laboratory DirectorAnthony C. Iwelunmor
Laboratory Phone(770) 800-3277
Laboratory LocationIcecare, LLC Dba Vitalcare Express976 Mansell Road, Roswell, GA 30075
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Icecare LLC's NPI number?

The NPI number for Icecare LLC is 1366202236. It was assigned to this organization in the NPPES registry on March 19, 2024. The provider is doing business as VitalCare Express.

Where is Icecare LLC located?

Icecare LLC is located at 976 Mansell Rd, Roswell, GA 30076. The listed phone number is (770) 800-3277.

What is Icecare LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Icecare LLC enrolled in Medicare?

Yes. Icecare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Icecare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 4 Medicare specialties reassign their Medicare billing to Icecare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (9), Family Practice (1) and Nephrology (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Icecare LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2305935) is associated with this NPI, valid through June 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Icecare LLC was last updated on March 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.