Individual provider Active NPI

Delana Lynn Job, LPN

  • Licensed Practical Nurse
  • Dallas, GA
National Provider Identifier
1679292122
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN082688 Issued in GA
Practice address
311 White Ingram Pkwy
Dallas, GA 30132-0969
Phone
(678) 363-7447
NPI assigned
Aug 26, 2022
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN082688 GA Primary

Addresses

Primary practice location

311 White Ingram Pkwy
Dallas, GA 30132-0969

Mailing address

311 White Ingram Pkwy # 301
Dallas, GA 30132-0969
Phone (678) 363-7447

Other names 1

  • Delana Lynn Quinones Former name

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

State licenses

LicenseStateTypeSpecialty
LPN082688GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia CTC, LLC CurrentSince Aug 28, 2022 Accepting new patients

Locations

311 White Ingram Pkwy
Dallas, GA 30132
Phone (678) 363-7447

311 White Ingram Pkwy
#301
Dallas, GA 30132

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1679292122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 WHITE INGRAM PKWY # 301",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320969",
            "telephone_number": "678-363-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WHITE INGRAM PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320969",
            "telephone_number": "678-363-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOB",
        "first_name": "DELANA",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN082688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELANA",
            "last_name": "QUINONES",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.