Tashia Purnell, SERVICE COORDINATOR

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

210549 Issued in GA

Practice address

790 Oak Trail Dr
Marietta, GA 30062-7502

Phone

(770) 212-2170

Fax

(770) 783-8639

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tashia Bridges Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1649033507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-212-2170",
            "fax_number": "770-783-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-212-2170",
            "fax_number": "770-783-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURNELL",
        "first_name": "TASHIA",
        "credential": "SERVICE COORDINATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": "210549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TASHIA",
            "last_name": "BRIDGES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda Stephens Purcell, BCBA
• Pure Guardian Care LLC
• Pure Health Medicine LLC
• Pure Rehab Physical Therapy LLC
• Puresight Surgical LLC
• Meghan K Purohit, DO
• Tara C. Pursely, DMD
• Tanna Smith Purvis, R.D.,L.D.
• Pamela S Putnam, DC
• Terrance Putter, RBT

• Case Manager/Care Coordinator in Marietta, GA
• Providers in Marietta, GA by specialty
• Case Manager/Care Coordinator in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.