NPIMap

Organization Active NPI

Destiny Bound Management

  • Case Management Agency
  • Jonesboro, GA
National Provider Identifier
1396424164
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
DESTINY BOUND MANAGEMENT
Doing business as
Destiny Bound Management
Practice address
632 Bramble CT
Jonesboro, GA 30238-4402
Phone
(678) 707-2902
NPI assigned
Jul 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Ingrid Trice, BS IN MENTAL HEALTHNPI 1366808263
Title
Owner
Phone
(678) 707-2902

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

632 Bramble CT
Jonesboro, GA 30238-4402

Mailing address

632 Bramble CT
Jonesboro, GA 30238-4402
Phone (678) 707-2902

Other names 1

  • Destiny Bound Management Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1396424164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BRAMBLE CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384402",
            "telephone_number": "678-707-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BRAMBLE CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384402",
            "telephone_number": "678-707-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY BOUND MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "TRICE",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-707-2902",
        "authorized_official_credential": "BS IN MENTAL HEALTH"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Destiny Bound Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.