Blueprint TMS& Wellness Centers of America

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BLUEPRINT TMS& WELLNESS CENTERS OF AMERICA

Practice address

1635 Highway 34 E # C2
Newnan, GA 30265-2173

Phone

(678) 619-5151

NPI assigned

Aug 30, 2022

Organization subpart

No

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

Authorized official

Name

Crystal Nelson, MDNPI 1437356870

Title

Owner

Phone

(404) 859-2247

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.

• Crystal Lewis Nelson, MD

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1437356870
  Medicare reassignment NPD Authorized official
• Rachel Smith Ussery, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Newnan, GA
  • NPI 1538678511
  NPD (past)

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1073233193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 HIGHWAY 34 E # C2",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652173",
            "telephone_number": "678-619-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 HIGHWAY 34 E # C2",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652173",
            "telephone_number": "678-619-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEPRINT TMS& WELLNESS CENTERS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-859-2247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Blondeau, M.ED, LPC, NCC
• Evan Mitchell Bloom, DNP, APRN, PMHNP-BC
• Madison Blose, RBT
• Katie Blount
• Blueprint Psychiatry, LLC
• Jennifer Alice Boateng
• Bobbi Personal Care Home Inc.
• Sushanth Raghu Boda, DO
• Mitchell Boles, APRN
• Shannon Leigh Boles, PNP

• Psychiatry Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.