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

MS. Nadine Angela Ennis, PAC

Individual provider Medical Physician Assistant · NPI 1962571612

MS. Nadine Angela Ennis, PAC is a Physician Assistant in Atlanta, Georgia. Qualified in 2001, 25 years ago. Practices with Southwest Atlanta Nephrology, PC, a 9-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
25
Licensed in
GA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711
Phone: (404) 696-7300
Fax: (404) 699-3514
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 004493 (GA)

Record details

NPI number1962571612
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESSeptember 27, 2010

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Southwest Atlanta Nephrology, Pc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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