Individual provider Active NPI

Helen L Ross

  • Community/Behavioral Health Agency
  • Stone Mountain, GA
National Provider Identifier
1023368263
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
647 Bralorne Dr
Stone Mountain, GA 30087-4604
Phone
(972) 375-5350
Fax
(888) 769-7016
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

647 Bralorne Dr
Stone Mountain, GA 30087-4604

Mailing address

647 Bralorne Dr.
Stone Mountain, GA 30087
Phone (972) 375-5350

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

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1023368263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 BRALORNE DR.",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30087",
            "telephone_number": "972-375-5350",
            "fax_number": "888-769-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 BRALORNE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874604",
            "telephone_number": "972-375-5350",
            "fax_number": "888-769-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "HELEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.