NPIMap

Organization Active NPI

Divine Psychiatric Care, LLC

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1306373170
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN165081 Issued in GA
Legal business name
DIVINE PSYCHIATRIC CARE, LLC
Practice address
2651 Cedar Dr
Lawrenceville, GA 30043-1325
Phone
(251) 402-0450
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Tracy Carstarphen, APRNNPI 1043204969
Title
Owner/Provider
Phone
(251) 402-0450

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
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X RN165081 GA Primary

Addresses

Primary practice location

2651 Cedar Dr
Lawrenceville, GA 30043-1325

Mailing address

2651 Cedar Dr
Lawrenceville, GA 30043-1325
Phone (251) 402-0450

National Provider Directory

National Provider Directory
Tax ID family
Divine Psychiatric Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1306373170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 CEDAR DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300431325",
            "telephone_number": "251-402-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 CEDAR DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300431325",
            "telephone_number": "251-402-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PSYCHIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "CARSTARPHEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "251-402-0450",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN165081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.