N/a at Present Time, Will Be Working Contractprivateduty

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

CN0000047840 Issued in GA

Legal business name

N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY

Practice address

401A Boulevard
401Aboulevard
Lagrange, GA 30240-3009

Phone

(706) 333-9369

NPI assigned

Jul 28, 2015

Organization subpart

No

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

Authorized official

Name

Miss Lisa Potts, CERTIFIED NURSING AS

Title

Cna

Phone

(706) 333-9369

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1679958003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401A BOULEVARD",
            "address_2": "401ABOULEVARD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403009",
            "telephone_number": "706-333-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401A BOULEVARD",
            "address_2": "401ABOULEVARD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403009",
            "telephone_number": "706-333-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "POTTS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CNA",
        "authorized_official_telephone_number": "706-333-9369",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CERTIFIED NURSING AS"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "CN0000047840",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "AL",
            "license": "CN0000047840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keerthana Dwarakan Mugundu, MD
• Ashley Murphy
• Kennedy Murphy, B.S, D.D.S
• Tiffany Danielle Murphy, NP
• Shanequa Mussa, CADC11
• Jasmine Naheed, M.D.
• Madhavi M Naik, M.D.
• National Vision, Inc.
• National Vision, Inc.
• Donald C Neal Jr., DMD

• Nursing Care Agency in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.