Son Bang Mai, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN297370 Issued in GA

Practice address

83 Upper Riverdale Rd SW Ste 135
Riverdale, GA 30274-2631

Phone

(770) 907-7222

NPI assigned

Aug 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHEECD/Endpoint/FHEECD

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.

• Truecare Medical LLC

  • Internal Medicine Physician
  • Lilburn, GA
  • NPI 1528731205
  Medicare reassignment NPD
• Uni-One Medical Clinic LLC

  • Primary Care Clinic/Center
  • Jonesboro, GA
  • NPI 1952667628
  NPD (past)
• Unimedical,PC

  • Specialist
  • Forest Park, GA
  • NPI 1023186483
  NPD (past)

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1174136071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 UPPER RIVERDALE RD SW STE 135",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742631",
            "telephone_number": "770-907-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 UPPER RIVERDALE RD SW STE 135",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742631",
            "telephone_number": "770-907-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "SON",
        "middle_name": "BANG",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN297370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Lynds, MD
• Ralph Cornell Lyons, M.D.
• Nyka Maceno
• Kristina Maclauchlin
• Yvonne Mukosolu Maduka, MD
• Vikram Reddy Mandadi, MD
• Tyrone Mangum
• Balu S Mani, MD
• Saptak Piyush Mankad, MD
• Dwight Hannibal Manley, RBT

• Family Nurse Practitioner in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.