Organization Active NPI

MJR Enterprises, PC

  • Psychologist
  • Blue Ridge, GA
National Provider Identifier
1508155029
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MJR ENTERPRISES, PC
Practice address
146 Depot St Ste 201
Blue Ridge, GA 30513-8627
Phone
(706) 502-9404
Fax
(949) 862-5384
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Mr. A Ronald Seifert, PHD
Title
Owner
Phone
(360) 698-1321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

146 Depot St Ste 201
Blue Ridge, GA 30513-8627

Mailing address

146 Depot St Ste 201
Blue Ridge, GA 30513-8627
Phone (706) 502-9404

Other names 1

  • A. Ronald Seifert PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241125003272 GA Part B Supplier - Clinic/Group Practice 2567631914 Receives reassigned benefits from 1 practitioner
Practice locations: Blue Ridge, GA

National Provider Directory

National Provider Directory

Locations

9395 Linder Way NW
#202A
Silverdale, WA 98383
Phone (360) 698-1321

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1508155029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 DEPOT ST STE 201",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305138627",
            "telephone_number": "706-502-9404",
            "fax_number": "949-862-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 DEPOT ST STE 201",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305138627",
            "telephone_number": "706-502-9404",
            "fax_number": "949-862-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJR ENTERPRISES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "SEIFERT",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-698-1321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A. Ronald Seifert PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.