NPIMap

Organization Active NPI

Innovative Infusions, LLC

  • Infusion Therapy Clinic/Center
  • Decatur, GA
National Provider Identifier
1366199739
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
INNOVATIVE INFUSIONS, LLC
Practice address
114 E Trinity PL
Decatur, GA 30030-3302
Phone
(470) 235-2832
NPI assigned
Mar 7, 2022
Organization subpart
Yes
Parent organization
INNOVATIVE INFUSIONS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Amy Mulderry
Title
President
Phone
(972) 588-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

114 E Trinity PL
Decatur, GA 30030-3302

Mailing address

3033 W President George Bush Hwy Ste 100
Plano, TX 75075-5752
Phone (210) 347-7459

Other names 1

  • Paragon Infusion Centers Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address licensingteam@paragonhealthcare.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Innovative Infusions LLC21 organizations share this tax ID, including this one
Part of
Innovative Infusions LLC

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1366199739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W PRESIDENT GEORGE BUSH HWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755752",
            "telephone_number": "210-347-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "470-235-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE INFUSIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNOVATIVE INFUSIONS, LLC",
        "enumeration_date": "2022-03-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "MULDERRY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-588-1000"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "licensingteam@paragonhealthcare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "114 E Trinity Pl",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300303302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Paragon Infusion Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paragon Infusion Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.