NPIMap

Organization Active NPI

Aimergency Connect Psychcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Conyers, GA
National Provider Identifier
1205519907
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
AIMERGENCY CONNECT PSYCHCARE
Practice address
1775 Parker Rd SE Ste C210
Conyers, GA 30094-6676
Phone
(561) 231-2594
Fax
(833) 449-5237
NPI assigned
Aug 9, 2023
Last updated
Apr 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Authorized official

Name
Alexis Daly
Title
Authorized Official
Phone
(954) 686-6577

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

1775 Parker Rd SE Ste C210
Conyers, GA 30094-6676

Mailing address

PO Box 132
Covington, GA 30015-0132
Phone (954) 686-6577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230831003073 GA Part B Supplier - Clinic/Group Practice 3971966300 Receives reassigned benefits from 3 practitioners
Practice locations: Conyers, GA
O20230831004813 FL Part B Supplier - Clinic/Group Practice 3971966300 Receives reassigned benefits from 2 practitioners
Practice locations: Tamarac, FL
O20240109003725 TX Part B Supplier - Clinic/Group Practice 3971966300 Receives reassigned benefits from 2 practitioners
Practice locations: Wylie, TX

National Provider Directory

National Provider Directory

Locations

5130 Linton Blvd
Ste B1
Delray Beach, FL 33484

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713657600000",
    "number": "1205519907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300150132",
            "telephone_number": "954-686-6577",
            "fax_number": "954-245-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 PARKER RD SE STE C210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946676",
            "telephone_number": "561-231-2594",
            "fax_number": "833-449-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIMERGENCY CONNECT PSYCHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "954-686-6577"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2024; 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.