His Hands Family Practice Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HIS HANDS FAMILY PRACTICE CLINIC LLC

Practice address

6011 Hendrix LN
Mableton, GA 30126-3483

Phone

(678) 559-5803

NPI assigned

Dec 23, 2020

Organization subpart

No

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

Authorized official

Name

Olatunde Synthia OlatunjiNPI 1316455066

Title

Owner

Phone

(678) 559-5803

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olatunde Synthia Olatunji

  • Family Nurse Practitioner
  • Mableton, GA
  • NPI 1316455066
  Medicare reassignment NPD Authorized official
• Kay Yetunde Johnson, NP

  • Family Nurse Practitioner
  • Smyrna, GA
  • NPI 1790167856
  Medicare reassignment NPD

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1003403163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 HENDRIX LN",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 HENDRIX LN",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263483",
            "telephone_number": "678-559-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS HANDS FAMILY PRACTICE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "OLATUNJI",
        "authorized_official_first_name": "OLATUNDE",
        "authorized_official_middle_name": "SYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-559-5803"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquis Tanisha Hebert
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• Helping Hands of Georgia, LLC
• Heritage Health LLC
• Louis Charles Hilliard, D.C.
• Home Away From Home
• Home Away From Home
• Romero Huffstead, PH.D.
• Abigail Lisa Hyde
• Icon Surgical

• Family Nurse Practitioner in Mableton, GA
• Providers in Mableton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.