Organization Active NPI

Unitedhands Health & Wellness Clinic LLC

  • Primary Care Nurse Practitioner
  • Morrow, GA
National Provider Identifier
1366045130
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
UNITEDHANDS HEALTH & WELLNESS CLINIC LLC
Practice address
1115 Mount Zion Rd
Morrow, GA 30260-2266
Phone
(404) 883-9140
NPI assigned
Nov 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Vera Mahou, NPNPI 1598278558
Title
NP-C
Phone
(404) 883-9140

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1115 Mount Zion Rd
Morrow, GA 30260-2266

Mailing address

1001 Reddy Farm Rd
Grayson, GA 30017-1754
Phone (404) 883-9140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210112003156 GA Part B Supplier - Clinic/Group Practice 7012320013 Receives reassigned benefits from 4 practitioners
Practice locations: Morrow, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2209202Unitedhands Health & Wellness Clinic LLC1115 Mount Zion Road Suite J, Morrow, GA 30260Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory

Locations

1115 Mount Zion Rd
Morrow, GA 30260
Phone (404) 883-9140

4864 Jimmy Carter Blvd
Norcross, GA 30093
Phone (678) 280-6630

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22835/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1366045130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 REDDY FARM RD",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171754",
            "telephone_number": "404-883-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 MOUNT ZION RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602266",
            "telephone_number": "404-883-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITEDHANDS HEALTH & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-16",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "MAHOU",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "NP-C",
        "authorized_official_telephone_number": "404-883-9140",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.