Active NPI
Joint Health and Wellness of Georgia LLC
- Internal Medicine Physician
- Griffin, GA
National Provider Identifier
1619631355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- JOINT HEALTH AND WELLNESS OF GEORGIA LLC
- Practice address
- 230 W College St Ste C
Griffin, GA 30224-4249 - Phone
- (678) 871-3735
- NPI assigned
- Oct 28, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Derek Shahn Hall
- Title
- Managing Member
- Phone
- (404) 734-8139
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Medical Specialty Clinic/Center | 261QM2500X |
Addresses
Primary practice location
230 W College St Ste C
Griffin, GA 30224-4249
Mailing address
230 W College St Ste C
Griffin, GA 30224-4249
Phone (678) 871-3735
Other practice location 1
718 S 8th St Ste B
Griffin, GA 30224-4827
Phone (404) 734-8139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
718 S 8th St
#B
Griffin, GA 30224
Phone (770) 228-1711
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Griffin, GA
- NPI 1467745422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729123200000",
"number": "1619631355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 W COLLEGE ST STE C",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244249",
"telephone_number": "678-871-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 W COLLEGE ST STE C",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244249",
"telephone_number": "678-871-3735"
}
],
"practiceLocations": [
{
"address_1": "718 S 8th St Ste B",
"address_purpose": "LOCATION",
"city": "Griffin",
"state": "GA",
"postal_code": "302244827",
"country_code": "US",
"telephone_number": "404-734-8139",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "JOINT HEALTH AND WELLNESS OF GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-28",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "DEREK",
"authorized_official_middle_name": "SHAHN",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "404-734-8139",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Griffin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.