Individual provider Active NPI

Valencia Tutein

  • Surgical Physician Assistant
  • Conyers, GA
National Provider Identifier
1003268756
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
272947085 Issued in GA
Practice address
1600 Sugarmaple LN SW
Conyers, GA 30094-6282
Phone
(770) 985-4257
Fax
(770) 985-4258
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 272947085 GA Primary

Addresses

Primary practice location

1600 Sugarmaple LN SW
Conyers, GA 30094-6282

Mailing address

1600 Sugarmaple LN SW
Conyers, GA 30094-6282
Phone (770) 985-4257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lencia Technology LLC Surgical CurrentSince Dec 12, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1003268756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SUGARMAPLE LN SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946282",
            "telephone_number": "770-985-4257",
            "fax_number": "770-985-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SUGARMAPLE LN SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946282",
            "telephone_number": "770-985-4257",
            "fax_number": "770-985-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTEIN",
        "first_name": "VALENCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "272947085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.