NPIMap

Organization Active NPI

Avesta Care Medical Staffing, LLC

  • Licensed Practical Nurse
  • Montgomery, AL
National Provider Identifier
1326522004
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
AVESTA CARE MEDICAL STAFFING, LLC
Practice address
5853 Brewbaker Blvd
Montgomery, AL 36116
Phone
(334) 316-5080
NPI assigned
Sep 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Authorized official

Name
Regina Mitchell, LPNNPI 1164904660
Title
Owner
Phone
(334) 316-5080

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X Primary
Nurse's AideGroup: 193200000X MULTI-SPECIALTY GROUP 376K00000X

Addresses

Primary practice location

5853 Brewbaker Blvd
Montgomery, AL 36116

Mailing address

5853 Brewbaker Blvd
Montgomery, AL 36116-4259
Phone (334) 316-5080

Other practice location 1

5853 Brewbaker Blvd
Montgomery, AL 36116-4259
Phone (334) 316-5080

National Provider Directory

National Provider Directory
Tax ID family
Avesta Care Medical Staffing LLC2 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": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1326522004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5853 BREWBAKER BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361164259",
            "telephone_number": "334-316-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5853 BREWBAKER BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36116",
            "telephone_number": "334-316-5080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5853 Brewbaker Blvd",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361164259",
            "country_code": "US",
            "telephone_number": "334-316-5080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVESTA CARE MEDICAL STAFFING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-316-5080",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.