Dynamic Healthcare

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

230003 Issued in GA

Legal business name

DYNAMIC HEALTHCARE

Practice address

130 Eagle Spring CT
Suite a
Stockbridge, GA 30281-7274

Phone

(678) 616-2273

NPI assigned

Aug 13, 2014

Last updated

Aug 13, 2014By 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

Bridget Randolph, NP

Title

Nurse Practitioner

Phone

(405) 414-6002

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1366851552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 EAGLE SPRING CT",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817274",
            "telephone_number": "678-616-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EAGLE SPRING CT",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817274",
            "telephone_number": "678-616-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "405-414-6002",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "230003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simonne Dupre, M.D.
• Blanca Ileana Durand, M.D.
• Hina Khan Durani, MD
• Rasheta Lawayne Duval, APRN
• Bernard Duvivier
• Dynamic Kids Therapy Services
• E Cares Nursing Staff Services
• E-Z Ride Home Transportation Services LLC
• Eagle Chiropractic Clinic Inc
• Eagle's Landing Longevity Center

• Family Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.