Yay God Boo Devil LLC

Primary specialty

Rehabilitation Registered NurseTaxonomy code 163WR0400X

License

RN113796 Issued in GA

Legal business name

YAY GOD BOO DEVIL LLC

Doing business as

Placidus Health & Wellness

Practice address

321 Washington Commons Dr
Evans, GA 30809-3170

Phone

(706) 231-5552

NPI assigned

Nov 20, 2014

Last updated

Nov 20, 2014By 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

Ms. Carroll Marie Kelly, RNNPI 1780081661

Title

Owner

Phone

(706) 231-5552

Specialties & licenses 2

Addresses

Other names 1

• Placidus Health & Wellness Doing business as

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.

• Carroll Marie Kelly, RN

  • Mechanotherapist
  • Evans, GA
  • NPI 1780081661
  NPD (past) Authorized official

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1588061469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 MARYLAND AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045316",
            "telephone_number": "706-231-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 WASHINGTON COMMONS DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093170",
            "telephone_number": "706-231-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAY GOD BOO DEVIL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-231-5552",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "GA",
            "license": "RN113796",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "RN113796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Placidus Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Curtis Wright, DMD
• Andrea Wynkoop, LMSW
• Ellis Lamar Wynn IV, CRNA
• X Factor EMS
• Hemant K. Yagnick, MD
• Ashlee Nicole Crouse Young, MS, LCPC, LPC
• Gertrude Kile Young, PHARMD
• Jeanette Young, ED.D,CCC-SLP
• Micah Young
• Sunitha Zechariah, MS RD LD CNSC FAND

• Rehabilitation Registered Nurse in Evans, GA
• Providers in Evans, GA by specialty
• Rehabilitation Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.