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GRACE TAMU FOMUNUNG NURSE PRACTITIONER
NPI 1679028575
Nurse Practitioner - Psychiatric/Mental Health in Dacula, GA

Active since August 20, 2016PECOS EnrolledAccepts Medicare Assignment
3206 THIMBLEBERRY TRL, DACULA, GA 30019(404) 819-7338 Get Directions Write a Review

NPPES record last updated: November 7, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 7, 2019, Aug 20, 2016 (2 updates tracked since 2016).

About Grace Tamu Fomunung Nurse Practitioner NPPES

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

GRACE TAMU FOMUNUNG NURSE PRACTITIONER (NPI 1679028575) is an individual psychiatric/mental health provider in Dacula, Georgia, licensed in Georgia (RN201867) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1679028575
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameGRACE TAMU FOMUNUNGCredential: NURSE PRACTITIONER
Location Address3206 THIMBLEBERRY TRLDacula, GA 30019-7299
Mailing Address3206 Thimbleberry TrlDacula, GA 30019-7299 · (404) 819-7338
Phone(404) 819-7338
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 20, 2016
Last NPPES UpdateNovember 7, 20192 updates tracked since enumeration
✔ NPI 1679028575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in GA · RN201867
Also ListedRegistered NurseTaxonomy 163W00000X · License RN201867 (GA)
3206 THIMBLEBERRY TRL, Dacula, GA 30019
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Other Names 1

Former Name (1)Grace Carothers

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Grace Tamu Fomunung Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759765886
PECOS Enrollment IDI20220908001862
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
75 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEHOVAHS BEHAVIORAL CARE LLC
Nurse Practitioner (Psychiatric/Mental Health)
3206 THIMBLEBERRY TRL
DACULA, GA 30019
Gwinnett County (404) 819-7338

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 Grace Fomunung's NPI number?

The NPI number for Grace Fomunung is 1679028575. It was assigned to this individual provider in the NPPES registry on August 20, 2016. The provider is also known as Grace Carothers.

Where is Grace Fomunung located?

Grace Fomunung practices at 3206 Thimbleberry Trl, Dacula, GA 30019. The listed phone number is (404) 819-7338.

What is Grace Fomunung's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Grace Fomunung enrolled in Medicare?

Yes. Grace Fomunung is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Grace Fomunung accept?

Health plans from Providence Health Plan and UnitedHealthcare list Grace Fomunung as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grace Fomunung was last updated on November 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.