Silver Wheel Moblie Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

075206 Issued in GA

Legal business name

SILVER WHEEL MOBLIE CARE

Practice address

1276 Cedar Keys CT
Stone Mountain, GA 30083-1811

Phone

(404) 789-7222

Fax

(678) 705-3717

NPI assigned

Oct 16, 2016

Last updated

Oct 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beverly Idris, LVN

Title

Owner

Phone

(404) 789-7222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476576000000",
    "number": "1346791290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 CEDAR KEYS CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300831811",
            "telephone_number": "404-789-7222",
            "fax_number": "678-705-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 CEDAR KEYS CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300831811",
            "telephone_number": "404-789-7222",
            "fax_number": "678-705-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER WHEEL MOBLIE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-16",
        "last_updated": "2016-10-16",
        "status": "A",
        "authorized_official_last_name": "IDRIS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-789-7222",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "075206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Stone Mountain, GA
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• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2016; 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.