Amy C Musselman, ATC

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

11-1114 Issued in GA

Practice address

2045 Peachtree Rd NE
Atlanta, GA 30309-1414

Phone

(678) 732-1332

Fax

(404) 425-1622

NPI assigned

Sep 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1275840639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11024 PERIMETER TRCE E",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303461931",
            "telephone_number": "678-732-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "678-732-1332",
            "fax_number": "404-425-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSELMAN",
        "first_name": "AMY",
        "middle_name": "C",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "GA",
            "license": "11-1114",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tyra Mussington
• Andrea Iman Mustafa, PHD
• Kamilah Subira Mustafa
• Malaka Mustafa

• All providers in Atlanta, GA
• Surgical Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2012; 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.