Individual provider Active NPI

Genise Collins

  • Nurse's Aide
  • Moultrie, GA
National Provider Identifier
1497354831
Registry record updated Oct 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0028840148 Issued in GA
Practice address
202 Robin LN
Moultrie, GA 31788-7281
Phone
(229) 921-9814
NPI assigned
Oct 17, 2020
Last updated
Oct 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0028840148 GA Primary

Addresses

Primary practice location

202 Robin LN
Moultrie, GA 31788-7281

Mailing address

202 Robin LN
Moultrie, GA 31788-7281
Phone (229) 921-9814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CN0028840148GAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1602892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602892800000",
    "number": "1497354831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ROBIN LN",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887281",
            "telephone_number": "229-921-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ROBIN LN",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887281",
            "telephone_number": "229-921-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "GENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-17",
        "last_updated": "2020-10-17",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0028840148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

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