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PURE HEALTH MEDICINE LLC
NPI 1548833452
Nurse Practitioner - Family in Marietta, GA

Active since July 19, 2021
905 SADDLE HL, MARIETTA, GA 30068(678) 842-8835 Get Directions Write a Review

NPPES record last updated: September 24, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 24, 2021, Jul 19, 2021 (2 updates tracked since 2021).

About Pure Health Medicine Llc NPPES

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

PURE HEALTH MEDICINE LLC (NPI 1548833452) is a healthcare organization registered as a family in Marietta, Georgia and active in the NPI registry since July 2021. The organization lists Paulette Decontee Kpannah, Owner, as its authorized official.

NPPES Registry Identity

NPI1548833452
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePURE HEALTH MEDICINE LLC
Location Address905 SADDLE HLMarietta, GA 30068-4915
Mailing Address3966 Jefferson Township PkwyMarietta, GA 30066-1704 · (678) 523-3663
Phone(678) 842-8835
Organization SubpartNo
Authorized OfficialPaulette Decontee KpannahOwner · (678) 523-3663
Enumeration DateJuly 19, 2021
Last NPPES UpdateSeptember 24, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2021
✔ NPI 1548833452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
905 SADDLE HL, Marietta, GA 30068
Open in Google Maps ↗

Other Names 1

Doing Business AsPure Health Medicine Llc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20211006001231Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pure Health Medicine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Paulette Kpannah, FNP
Nurse Practitioner
NPI 1740882877
905 SADDLE HL
Marietta, GA 30068
(678) 523-3663
✔ PECOSSame address

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

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 Pure Health Medicine LLC's NPI number?

The NPI number for Pure Health Medicine LLC is 1548833452. It was assigned to this organization in the NPPES registry on July 19, 2021.

Where is Pure Health Medicine LLC located?

Pure Health Medicine LLC is located at 905 Saddle Hl, Marietta, GA 30068. The listed phone number is (678) 842-8835.

What is Pure Health Medicine LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Pure Health Medicine LLC enrolled in Medicare?

Yes. Pure Health Medicine LLC is registered in the Medicare PECOS enrollment system.

When is Pure Health Medicine LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Pure Health Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Pure Health Medicine 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pure Health Medicine LLC was last updated on September 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.