Minvervas Multidisciplinary Health Solutions LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MINVERVAS MULTIDISCIPLINARY HEALTH SOLUTIONS LLC

Practice address

2941 Stonecrest LN
Lithonia, GA 30038-2472

Phone

(310) 709-6284

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Herretta Lachell Pickens, NP

Title

Owner

Phone

(310) 709-6284

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1285108241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 STONECREST LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382472",
            "telephone_number": "310-709-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 STONECREST LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382472",
            "telephone_number": "310-709-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINVERVAS MULTIDISCIPLINARY HEALTH SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "PICKENS",
        "authorized_official_first_name": "HERRETTA",
        "authorized_official_middle_name": "LACHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-709-6284",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.