Organization Active NPI

Fortune Global Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1205531647
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FORTUNE GLOBAL PSYCHIATRY LLC
Practice address
1720 Peachtree St NW Ste 1010C
Atlanta, GA 30309-2449
Phone
(401) 688-0680
NPI assigned
Apr 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Maima FortuneNPI 1598240822
Title
Owner
Phone
(401) 688-0680

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1720 Peachtree St NW Ste 1010C
Atlanta, GA 30309-2449

Mailing address

1720 Peachtree St NW Ste 1010C
Atlanta, GA 30309-2449
Phone (401) 688-0680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504002677 GA Part B Supplier - Clinic/Group Practice 1557726072 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

1720 Peachtree St NW
Ste 1010C
Atlanta, GA 30309
Phone (401) 688-0680

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": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1205531647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE ST NW STE 1010C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092449",
            "telephone_number": "401-688-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE ST NW STE 1010C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092449",
            "telephone_number": "401-688-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTUNE GLOBAL PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "FORTUNE",
        "authorized_official_first_name": "MAIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-688-0680"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.