Family Health & Wellness Group LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

FAMILY HEALTH & WELLNESS GROUP LLC

Practice address

245 Park Haven LN
Tyrone, GA 30290-1719

Phone

(678) 541-1187

NPI assigned

Feb 26, 2024

Last updated

Mar 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mariama Diallo, AGACNP-BCNPI 1891317889

Title

Owner

Phone

(678) 541-1187

Specialties & licenses 1

Addresses

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.

• Mariama Diallo, AGACNP-BC

  • Adult Health Nurse Practitioner
  • Decatur, GA
  • NPI 1891317889
  Authorized official Same address or phone

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1578329645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PARK HAVEN LN",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901719",
            "telephone_number": "678-541-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PARK HAVEN LN",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901719",
            "telephone_number": "678-541-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH & WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "DIALLO",
        "authorized_official_first_name": "MARIAMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-541-1187",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AGACNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.