Mulberry Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MULBERRY PRIMARY CARE LLC

Practice address

831 Auburn Rd Ste 230
Dacula, GA 30019-5437

Phone

(678) 232-7332

Fax

(470) 300-1100

NPI assigned

Jan 18, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Jocilli Walton, FNPNPI 1174089452

Title

FNP

Phone

(678) 736-0460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jocilli Walton

  • Family Medicine Physician
  • Dacula, GA
  • NPI 1174089452
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1689435448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 WILDFLOWER WAY",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305483653",
            "telephone_number": "678-736-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 AUBURN RD STE 230",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195437",
            "telephone_number": "678-232-7332",
            "fax_number": "470-300-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "JOCILLI",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "678-736-0460",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Carol Moss, NP
• Andrew David Mote, PHARM.D
• Iman Moton
• James R Moulton II, M.D.
• Hala Muhanna, PHARM.D.
• Multi-Lingual Speech Group, LLC
• Thulasiswarnalatha Muppuru, DDS
• Tyler Joseph Musselwhite, PT
• Clare Mutters, PTA
• Tina Maambo Mwale, RN

• Family Medicine Physician in Dacula, GA
• Providers in Dacula, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.