Organization Active NPI

Luminous Care, LLC

  • Health Service Clinic/Center
  • Atlanta, GA
National Provider Identifier
1467066639
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LUMINOUS CARE, LLC
Practice address
285 Boulevard NE Ste 145
Atlanta, GA 30312-4204
Phone
(844) 884-9691
Fax
(404) 907-4052
NPI assigned
Sep 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Ms. Andrea Jefferson-SaboorNPI 1407895618
Title
FNP
Phone
(404) 354-6988

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

285 Boulevard NE Ste 145
Atlanta, GA 30312-4204

Mailing address

1132 Liberty Pkwy NW
Atlanta, GA 30318-9377
Phone (404) 354-6988

Other identifiers 1

IdentifierTypeStateIssuer
000899643MedicaidGA

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1467066639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 LIBERTY PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303189377",
            "telephone_number": "404-354-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD NE STE 145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124204",
            "telephone_number": "844-884-9691",
            "fax_number": "404-907-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOUS CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON-SABOOR",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "404-354-6988",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000899643",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.