Active NPI
Mavis K Mensah, RN
- Registered Nurse
- Chamblee, GA
National Provider Identifier
1366793945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN110178
- Practice address
- 3807 Clairmont Rd
Chamblee, GA 30341-4911 - Phone
- (770) 454-1144
- Fax
- (770) 452-4470
- NPI assigned
- Sep 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN110178 | GA | Primary |
Addresses
Primary practice location
3807 Clairmont Rd
Chamblee, GA 30341-4911
Mailing address
314 Cabaret CT SW
Marietta, GA 30064-3618
Phone (770) 912-2436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN110178 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1366793945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 CABARET CT SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300643618",
"telephone_number": "770-912-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 CLAIRMONT RD",
"city": "CHAMBLEE",
"state": "GA",
"postal_code": "303414911",
"telephone_number": "770-454-1144",
"fax_number": "770-452-4470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENSAH",
"first_name": "MAVIS",
"middle_name": "K",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-24",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN110178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chamblee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.