Epiphany Healthcare Systems, Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EPIPHANY HEALTHCARE SYSTEMS, INC

Doing business as

Accessible Healthcare of South Atlanta

Practice address

4405 Mall Blvd
Suite 315
Union City, GA 30291-2044

Phone

(770) 306-3416

Fax

(770) 306-3417

NPI assigned

Oct 11, 2016

Organization subpart

No

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

Authorized official

Name

Dickson Osanu, RN, MBA

Title

Ceo

Phone

(770) 306-3415

Specialties & licenses 8

Addresses

Other names 1

• Accessible Healthcare of South Atlanta Doing business as

Tax ID family

Epiphany Healthcare System Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Epiphany Healthcare System, Inc

  dba Accessible Health Care of South Atlanta

  • Home Health Agency
  • Tyrone, GA
  • NPI 1124202973
  NPD tax ID
• Epiphany Healthcare System, Inc

  • Mental Health Counselor
  • Hammond, LA
  • NPI 1730660176
  NPD tax ID

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1578013751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "address_2": "SUITE 315",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "770-306-3416",
            "fax_number": "770-306-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "address_2": "SUITE 315",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "770-306-3416",
            "fax_number": "770-306-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY HEALTHCARE SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "OSANU",
        "authorized_official_first_name": "DICKSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-306-3415",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Accessible Healthcare of South Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Union City, GA
• Providers in Union City, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.