Venna Reese, HEALTH PROFESSION

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

4027 Prescott Dr
Martinez, GA 30907-4308

Phone

(706) 284-9959

Fax

(706) 955-8425

NPI assigned

Oct 26, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mount Eagle Wings Personal Care Home, Inc

  • Adult Care Home Facility
  • Martinez, GA
  • NPI 1619204906
  NPD (past) Authorized official
• Mount Eagles Wings Inc

  • Developmental Disabilities Clinic/Center
  • Martinez, GA
  • NPI 1104182864
  NPD (past) Authorized official

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1659607661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 PRESCOTT DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309074308",
            "telephone_number": "706-284-9959",
            "fax_number": "706-955-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 PRESCOTT DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309074308",
            "telephone_number": "706-284-9959",
            "fax_number": "706-955-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "VENNA",
        "name_prefix": "Ms.",
        "credential": "HEALTH PROFESSION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis Allen Raborn Jr.
• Nicolette Ramirez
• Randy Georgemiller, PH.D., P.C.
• Monique Rauls
• Reed Creek Dental LLC
• David Earl Reid, D.D.S.
• William Alexander Reid, MD
• Elizabeth Graham Reiter, LAPC
• Release Restore Redefine Counseling LLC
• Reliance Medical Supply, Inc.

• Developmental Disabilities Clinic/Center in Martinez, GA
• Providers in Martinez, GA by specialty
• Developmental Disabilities Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.