Organization Active NPI

Guardian Health Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucker, GA
National Provider Identifier
1679181168
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GUARDIAN HEALTH GROUP
Practice address
4228 1St Ave Ste 1a
Tucker, GA 30084-4426
Phone
(866) 939-9929
Fax
(470) 761-4181
NPI assigned
Jul 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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

Authorized official

Name
Miss Marie-Andree Parent, NURSE PRACTITIONERNPI 1639539125
Title
NP
Phone
(516) 647-1557

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4228 1St Ave Ste 1a
Tucker, GA 30084-4426

Mailing address

4228 1St Ave Ste 1a
Tucker, GA 30084-4426
Phone (866) 939-9929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201005000097 GA Part B Supplier - Clinic/Group Practice 7113346578 Receives reassigned benefits from 1 practitioner
Practice locations: Acworth, GA

National Provider Directory

National Provider Directory

Locations

4228 1st Ave
Ste 1A
Tucker, GA 30084
Phone (866) 939-9929

Practitioners & affiliated clinicians

Practitioners 2

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": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722729600000",
    "number": "1679181168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 1ST AVE STE 1A",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844426",
            "telephone_number": "866-939-9929",
            "fax_number": "470-761-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 1ST AVE STE 1A",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844426",
            "telephone_number": "866-939-9929",
            "fax_number": "470-761-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A",
        "authorized_official_last_name": "PARENT",
        "authorized_official_first_name": "MARIE-ANDREE",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "516-647-1557",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.