Individual provider Active NPI

Sophia Robinson-Harris, FNP

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1124570643
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN237690 Issued in GA
Practice address
2892 Antonia PL NW
Kennesaw, GA 30152-7430
Phone
(140) 474-9974
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN237690 GA Primary

Addresses

Primary practice location

2892 Antonia PL NW
Kennesaw, GA 30152-7430

Mailing address

2892 Antonia PL NW
Kennesaw, GA 30152-7430
Phone (140) 474-9974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN237690GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindcare Wellness LLC Family Current Accepting new patients

Organizations & group practices 1

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": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1124570643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2892 ANTONIA PL NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527430",
            "telephone_number": "140-474-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2892 ANTONIA PL NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527430",
            "telephone_number": "140-474-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON-HARRIS",
        "first_name": "SOPHIA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.