Georgia PHS PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GEORGIA PHS PC

Practice address

3355 Lenox Rd NE
Suite 750
Atlanta, GA 30326-1394

Phone

(877) 260-4747

Fax

(901) 261-4867

NPI assigned

May 7, 2012

Organization subpart

No

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

Authorized official

Name

Nicole Howard

Title

Cfo

Phone

(337) 991-9276

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1073872487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DRIVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 LENOX RD NE",
            "address_2": "SUITE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261394",
            "telephone_number": "877-260-4747",
            "fax_number": "901-261-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PHS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-07",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125161A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Palliative Care Services LLC
• Georgia Parent Support Network, Inc. (GPSN)
• Georgia Pediatric Psychology, Inc.
• Georgia Pediatric Pulmonology Associates, P.C.
• Georgia Perinatal Centers, Inc.
• Georgia Physicians of Cardiology, LLC
• Georgia Plastic Surgery
• Georgia Premium Personal Care
• Georgia Prosthetics, Inc. (Restorative Prosthetics & Orthotics)
• Georgia Protoncare Center, Inc. (Emory Proton Therapy Center)

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.