Organization Active NPI

It'S a Draw

  • Clinical Medical Laboratory
  • Snellville, GA
National Provider Identifier
1114698040
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
IT'S A DRAW
Practice address
1970 Main St E Ste B3
Snellville, GA 30078-6463
Phone
(470) 467-4680
NPI assigned
Sep 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Sharonda Forte, NURSE PRACTITIONERNPI 1811134133
Title
Ceo
Phone
(270) 987-1338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

1970 Main St E Ste B3
Snellville, GA 30078-6463

Mailing address

1970 Main St E Ste B3
Snellville, GA 30078-6463
Phone (470) 467-4680

Other identifiers 2

IdentifierTypeStateIssuer
003246533AMedicaidGA
11D2235621OtherGAMOBILE LAB

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.itsadraw.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220324000331 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8921496704 Practice locations: Snellville, GA

National Provider Directory

National Provider Directory

Locations

2274 Salem Rd SE
Ste 106411
Conyers, GA 30013
Phone (470) 467-4680

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1114698040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 MAIN ST E STE B3",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786463",
            "telephone_number": "470-467-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 MAIN ST E STE B3",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786463",
            "telephone_number": "470-467-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IT'S A DRAW",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "FORTE",
        "authorized_official_first_name": "SHARONDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-987-1338",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003246533A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOBILE LAB",
            "identifier": "11D2235621",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.itsadraw.net",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.itsadraw.net",
            "address_1": "2274 Salem Rd SE Ste 106-411",
            "city": "Conyers",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300132097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.