New Genesis Center for Intentional Health & Aesthetics

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

NEW GENESIS CENTER FOR INTENTIONAL HEALTH & AESTHETICS

Practice address

556 Hall Rd
Thomasville, GA 31757-8105

Phone

(229) 228-9050

Fax

(229) 228-9056

NPI assigned

Jun 23, 2008

Organization subpart

No

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

Authorized official

Name

Patrice Bullock, FNP-C

Title

Co-Owner

Phone

(229) 228-9050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1689835571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 HALL RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317578105",
            "telephone_number": "229-228-9050",
            "fax_number": "229-228-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 HALL RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317578105",
            "telephone_number": "229-228-9050",
            "fax_number": "229-228-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW GENESIS CENTER FOR INTENTIONAL HEALTH & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "229-228-9050",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cary Carter Newman, M.D.
• Jessica Newsome
• Joshua S. Newton, M.D.
• Kayla Nguyen
• Randi Grantham Nguyen, MED SLP

• Family Nurse Practitioner in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.