Pro Staff Medical, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

0724180 Issued in GA

Legal business name

PRO STAFF MEDICAL, LLC

Practice address

3906 Brookgate Dr
Ellenwood, GA 30294-2385

Phone

(404) 363-2239

Fax

(404) 363-2909

NPI assigned

Jul 13, 2007

Last updated

Jul 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Saundra R Payton

Title

Owner

Phone

(404) 363-2239

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1033318662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 BROOKGATE DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942385",
            "telephone_number": "404-363-2239",
            "fax_number": "404-363-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 BROOKGATE DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942385",
            "telephone_number": "404-363-2239",
            "fax_number": "404-363-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO STAFF MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "PAYTON",
        "authorized_official_first_name": "SAUNDRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-363-2239",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "0724180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Ellenwood, GA
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• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.