Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corwin Oswald Demattos

Individual provider Family Nurse Practitioner · NPI 1720617756

Corwin Oswald Demattos is a Nurse Practitioner in Grayson, Georgia. Qualified in 2019, 7 years ago. Practices with North Atlanta Professional Services LLC, a 423-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2020
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Practice location Address checks out

1637 Atlanta Hwy Ste A
Grayson, GA 30017-3001
Phone: (678) 344-8268
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 189365 (GA)

Record details

NPI number1720617756
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 2, 2020
Last updated in NPPESDecember 2, 2021
Certification dateNovember 23, 2021
Mailing address1637 Atlanta Hwy Suite A, Grayson, GA 30017-5942

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice North Atlanta Professional Services Llc — 423 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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