Golden Triangle Geriatric Collaborative, LLC

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

R850904 Issued in MS

Legal business name

GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC

Practice address

100 Wilburn Way
Starkville, MS 39759-3692

Phone

(662) 320-4008

Fax

(662) 323-6007

NPI assigned

Feb 20, 2012

Last updated

Feb 20, 2012By 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

Dr. Mary Atkinson Smith, FNP

Title

Managing Partner

Phone

(662) 320-4008

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1639442726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILBURN WAY",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593692",
            "telephone_number": "662-320-4008",
            "fax_number": "662-323-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILBURN WAY",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593692",
            "telephone_number": "662-320-4008",
            "fax_number": "662-323-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ATKINSON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "662-320-4008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MS",
            "license": "R850904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralesia J Gibbs, MSED.
• Shannon B Gibbs Jr., MS, ATC, LAT
• Alaina Gilbert, OT
• Gilbert's Hospice Care, LLC (Gentiva)
• Jessica Ann Gleason, RN
• Golden Triangle Healing Place Inc.
• Golden Triangle Oral and Facial Surgery & Dental Implant Center
• Golden Triangle Outpatient Center LLC
• Golden Triangle Planning & Development District Inc
• Golden Triangle Planning & Development District Inc

• Gerontology Clinical Nurse Specialist in Starkville, MS
• Providers in Starkville, MS by specialty
• Gerontology Clinical Nurse Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.