Bonserva Acute Primary Care Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BONSERVA ACUTE PRIMARY CARE CENTER

Practice address

4940 Governors Dr Ste 209
Forest Park, GA 30297-2186

Phone

(404) 366-8111

Fax

(404) 366-8102

NPI assigned

Aug 7, 2009

Organization subpart

No

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

Authorized official

Name

Camille Pleshette Cook, FNP

Title

Family Nurse Practitioner

Phone

(404) 366-8111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1295966216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 GOVERNORS DR STE 209",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972186",
            "telephone_number": "404-366-8111",
            "fax_number": "404-366-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 GOVERNORS DR STE 209",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972186",
            "telephone_number": "404-366-8111",
            "fax_number": "404-366-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONSERVA ACUTE PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_middle_name": "PLESHETTE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "404-366-8111",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.