Grands Premier Health & Lab Diagnostics LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC

Practice address

3347 Surveyor CT
Douglasville, GA 30135-8102

Phone

(770) 990-4699

NPI assigned

Jan 24, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Shantel Antoin Brown, FNPNPI 1538717475

Title

Owner

Phone

(770) 990-4699

Specialties & licenses 4

Addresses

Practitioners 1

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

• Shantel Brown, FNP

  • Family Nurse Practitioner
  • Dallas, GA
  • NPI 1538717475
  NPD Authorized official

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1184376931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3347 SURVEYOR CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358102",
            "telephone_number": "770-990-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3347 SURVEYOR CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358102",
            "telephone_number": "770-990-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHANTEL",
        "authorized_official_middle_name": "ANTOIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-990-4699",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Hearing and Language Services, LLC
• Grace Oasis Personal Care Home LLC
• Grace Walkers Center Transportation
• Shunte L Graham
• Kana Koenig Gramling, OTR/L
• Granger Dental Spa, PC
• Krystle Grant
• Tiffany C Grant
• Danielle Matrece Green-Watson, DPM
• Bryan Green, PHARMD

• Clinic/Center in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.