Individual provider Active NPI

Sandra Elizabeth McIntosh-Takori, FNP-C

  • Nurse Practitioner
  • Calhoun, GA
National Provider Identifier
1346724812
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN185100-NP Issued in GA
Practice address
189 Professional CT SE Ste 400
Calhoun, GA 30701-7053
Phone
(706) 624-1130
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN185100-NP GA Primary

Addresses

Primary practice location

189 Professional CT SE Ste 400
Calhoun, GA 30701-7053

Mailing address

189 Professional CT SE Ste 400
Calhoun, GA 30701-7053
Phone (706) 624-1130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514002600 GA Practitioner - Nurse Practitioner 0143651729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN185100-NPGAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Medhealth Nurse Practitioner PastSince Jul 28, 2019 Accepting new patients
Temple Medical LLC PastSince May 31, 2005 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26671/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1346724812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PROFESSIONAL CT SE STE 400",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307017053",
            "telephone_number": "706-624-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 PROFESSIONAL CT SE STE 400",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307017053",
            "telephone_number": "706-624-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH-TAKORI",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN185100-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

Verify at the official NPI Registry.