Active NPI
Tarneshia S Maddox
- Pastoral Counselor
- Sparta, GA
National Provider Identifier
1679138267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 1482 Underwood Rd
Sparta, GA 31087-9612 - Phone
- (478) 234-9283
- NPI assigned
- May 8, 2019
- Last updated
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | Primary |
Addresses
Primary practice location
1482 Underwood Rd
Sparta, GA 31087-9612
Mailing address
1482 Underwood Rd
Sparta, GA 31087-9612
Phone (478) 234-9283
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05 | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1679138267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1482 UNDERWOOD RD",
"city": "SPARTA",
"state": "GA",
"postal_code": "310879612",
"telephone_number": "478-234-9283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1482 UNDERWOOD RD",
"city": "SPARTA",
"state": "GA",
"postal_code": "310879612",
"telephone_number": "478-234-9283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "TARNESHIA",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-08",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sparta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.