Atlanta Foot Fairy LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

ATLANTA FOOT FAIRY LLC

Practice address

4810 Mockingbird LN
Douglasville, GA 30135-3616

Phone

(678) 544-6179

NPI assigned

Jun 4, 2025

Organization subpart

No

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

Authorized official

Name

Ms. Chantelle Morrison-Kourouma, BSN-RNNPI 1316273030

Title

Founder & Clinical Director

Phone

(678) 544-6179

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chantelle Morrison-Kourouma, RN

  • Registered Nurse
  • Detroit, MI
  • NPI 1316273030
  NPD Authorized official

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1447144407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 MOCKINGBIRD LN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301353616",
            "telephone_number": "678-544-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 MOCKINGBIRD LN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301353616",
            "telephone_number": "678-544-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA FOOT FAIRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "MORRISON-KOUROUMA",
        "authorized_official_first_name": "CHANTELLE",
        "authorized_official_title_or_position": "FOUNDER & CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "678-544-6179",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN-RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.