Individual provider Active NPI

Beverly Lynn Philson, PMHCNS-BC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Atlanta, GA
National Provider Identifier
1063651982
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN088054 Issued in GA
Practice address
80 Jesse Hill Jr Dr , SE
Atlanta, GA 30303-3801
Phone
(404) 616-4444
Fax
(404) 616-4737
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN088054 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr , SE
Atlanta, GA 30303-3801

Mailing address

80 Jesse Hill Jr Dr , SE
Atlanta, GA 30303-3801
Phone (404) 616-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000067 GA Practitioner - Certified Clinical Nurse Specialist (CNS) 6406989839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

10 Park PL NE
Atlanta, GA 30303-2511
Phone (404) 616-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
88054GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation Past Accepting new patients

Organizations & group practices 2

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": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1063651982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR , SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033801",
            "telephone_number": "404-616-4444",
            "fax_number": "404-616-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR , SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033801",
            "telephone_number": "404-616-4444",
            "fax_number": "404-616-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILSON",
        "first_name": "BEVERLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN088054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.