Due West Infusion

Primary specialty

Infusion Therapy Registered NurseTaxonomy code 163WI0500X

Legal business name

DUE WEST INFUSION

Practice address

6110 Pine Mountain Rd NW Ste 201
Kennesaw, GA 30152-3357

Phone

(770) 429-5555

Fax

(770) 429-5586

NPI assigned

Oct 12, 2021

Organization subpart

No

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

Authorized official

Name

Molly C Mattson

Title

Owner

Phone

(770) 722-9123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1487316873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 PINE MOUNTAIN RD NW STE 201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523357",
            "telephone_number": "770-429-5555",
            "fax_number": "770-429-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 PINE MOUNTAIN RD NW STE 201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523357",
            "telephone_number": "770-429-5555",
            "fax_number": "770-429-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUE WEST INFUSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-722-9123"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Bishop Driver, BCBA
• Dsi Kennesaw LLC
• DTJG Dental Group LLC
• Ryan William Dubinin
• Due West Chiropractic and Rehabilitation LLC
• Due West Integrated Health Center Physical Medicine, LLC
• Stephanie Dumas
• Amari Mekkhi Dunbar
• Kelly H Duncan, MS, CCC-SLP
• Paul Eric Duncan, DMD

• Infusion Therapy Registered Nurse in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Infusion Therapy Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.