Active NPI
Kimberly Maughon
- Counselor
- Conyers, GA
National Provider Identifier
1407568454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2375 Wall St SE Ste 240
Conyers, GA 30013-6702 - Phone
- (770) 299-9943
- Fax
- (470) 205-0228
- NPI assigned
- Dec 21, 2022
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2375 Wall St SE Ste 240
Conyers, GA 30013-6702
Mailing address
1006 Boogers Hill Rd
Oxford, GA 30054-3760
Phone (770) 712-5914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1407568454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 BOOGERS HILL RD",
"city": "OXFORD",
"state": "GA",
"postal_code": "300543760",
"telephone_number": "770-712-5914",
"fax_number": "470-205-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 WALL ST SE STE 240",
"city": "CONYERS",
"state": "GA",
"postal_code": "300136702",
"telephone_number": "770-299-9943",
"fax_number": "470-205-0228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUGHON",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.