Justin Vassell

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN169074 Issued in GA

Practice address

1903 Phoenix Boulevard
Suite 200
College Park, GA 30349

Phone

(678) 335-9010

Fax

(678) 229-9906

NPI assigned

Aug 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Access Mental Health Agency, LLC

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1881848174
  NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1114575859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 PHOENIX BLVD STE 200",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495700",
            "telephone_number": "678-335-9010",
            "fax_number": "678-229-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 PHOENIX BOULEVARD",
            "address_2": "SUITE 200",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "678-335-9010",
            "fax_number": "678-229-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSELL",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN169074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHIATRY",
            "identifier": "1881848174",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Everette R Umberger, D.C.
• Helen O Uzokwe, NP-C, DNP
• Sharcola Denise Vaughn, D.M.D.
• Victor J Blake & Associates
• Victor J Blake Associates
• Vision Consulting Partners, LLC
• Vital Sounds LLC

• Psychiatric/Mental Health Registered Nurse in College Park, GA
• Providers in College Park, GA by specialty
• Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.