NPIMap

Organization Active NPI

Medicinal Plus

  • Skilled Nursing Facility
  • Atlanta, GA
National Provider Identifier
1639619307
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
RPH26521 Issued in GA
Legal business name
MEDICINAL PLUS
Practice address
2443 Center Pointe Cir SW
Atlanta, GA 30315-7309
Phone
(470) 344-4696
NPI assigned
Feb 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Dr. Latasha Stallworth, PHARM DNPI 1548864671
Title
Owner
Phone
(404) 904-4282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X RPH26521 GA Primary

Addresses

Primary practice location

2443 Center Pointe Cir SW
Atlanta, GA 30315-7309

Mailing address

2443 Center Pointe Cir SW
Atlanta, GA 30315-7309
Phone (470) 344-4696

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1639619307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 CENTER POINTE CIR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157309",
            "telephone_number": "470-344-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 CENTER POINTE CIR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157309",
            "telephone_number": "470-344-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINAL PLUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "LATASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-904-4282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "RPH26521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.