MEDICARE: EMPOWERED PATHWAYS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	251B00000X	Case Management Agency
3	251E00000X	Home Health Agency
4	251S00000X	Community/Behavioral Health Agency
5	363LA2100X	Acute Care Nurse Practitioner
6	363LG0600X	Gerontology Nurse Practitioner
7	171M00000X	Case Manager/Care Coordinator
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
9	363LP2300X	Primary Care Nurse Practitioner
10	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1669121760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERED PATHWAYS LLC

Provider Business Mailing Address
First Line	:	3994 VILLA LAKE RD
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-5051
Country	:	US
Telephone Number	:	850-688-6761
Fax Number	:	678-840-3887

Provider Business Practice Location Address
First Line	:	3994 VILLA LAKE RD
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-5051
Country	:	US
Telephone Number	:	470-837-0175
Fax Number	:

Authorized Official
Title or Position	:	BILLING
Name	:	BROOKE T THOMPSON
Credential	:
Telephone Number	:	404-438-5751

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	01/26/2023

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Directions to “EMPOWERED PATHWAYS LLC ” Practice Location

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