Organization Active NPI

Womens Healthcare and Aesthetics

  • Specialist
  • Lithonia, GA
National Provider Identifier
1619000312
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
035507 Issued in GA
Legal business name
WOMENS HEALTHCARE AND AESTHETICS
Practice address
5910 Hillandale Dr Ste 201
Lithonia, GA 30058-1878
Phone
(770) 760-8484
Fax
(770) 760-7664
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Melanie McMullen
Title
Practice Manager
Phone
(770) 760-8484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 035507 GA Primary

Addresses

Primary practice location

5910 Hillandale Dr Ste 201
Lithonia, GA 30058-1878

Mailing address

1403 Manchester Dr NE
Conyers, GA 30012-3879
Phone (770) 760-8484

Other identifiers 1

IdentifierTypeStateIssuer
393403OtherGABC BS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619000312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 MANCHESTER DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123879",
            "telephone_number": "770-760-8484",
            "fax_number": "770-760-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 HILLANDALE DR STE 201",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581878",
            "telephone_number": "770-760-8484",
            "fax_number": "770-760-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS HEALTHCARE AND AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-760-8484"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "035507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "393403",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.