Bliss Primary and Urgent Care PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BLISS PRIMARY AND URGENT CARE PC

Practice address

4600 E Ponce de Leon Ave Ste a
Clarkston, GA 30021-1839

Phone

(404) 808-2125

Fax

(877) 779-5837

NPI assigned

Mar 9, 2018

Last updated

Mar 9, 2018By 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. Miles Johnson, MDNPI 1568419844

Title

Authorized Official

Phone

(404) 664-4578

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miles Johnson, M.D.

  • Family Medicine Physician
  • Fayetteville, GA
  • NPI 1568419844
  Authorized official Same address or phone

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1659874287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E PONCE DE LEON AVE STE A",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211839",
            "telephone_number": "404-808-2125",
            "fax_number": "877-779-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E PONCE DE LEON AVE STE A",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211839",
            "telephone_number": "404-808-2125",
            "fax_number": "877-779-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLISS PRIMARY AND URGENT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MILES",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "404-664-4578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Clarkston, GA
• Providers in Clarkston, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.