Jimmy'S Magnolia Tree Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

CLA001050 Issued in GA

Legal business name

JIMMY'S MAGNOLIA TREE INC

Practice address

1526 Westwood Ave SW
Atlanta, GA 30310-2316

Phone

(404) 748-9276

Fax

(404) 941-7929

NPI assigned

Sep 16, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Jan N Trotter

Title

Director

Phone

(404) 748-9276

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1699101147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WESTWOOD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102316",
            "telephone_number": "404-748-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WESTWOOD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102316",
            "telephone_number": "404-748-9276",
            "fax_number": "404-941-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY'S MAGNOLIA TREE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-748-9276",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": "CLA001050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP WAVIER",
            "identifier": "972175212A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tia Jimenez
• Bridgette Jimerson
• Christine Carol Jiminez, PA
• Kelley B Jimison, CPNP
• Jimmie E. Williams, M.D., P.C.
• Jindal Psychiatry, L.L.C.
• Gaurav Jindal, MD
• Hyder Jinnah, MD PHD
• Jireh Hospice LLC
• Fareem Jivraj, OD

• Developmentally Disabled Services Day Training Agency in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Developmentally Disabled Services Day Training Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.