Felicia M Mack, PCA

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

307 Kendrick Estates Dr
Jonesboro, GA 30238-2196

Phone

(678) 758-2092

NPI assigned

Oct 31, 2017

Last updated

Oct 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Felicia Brown Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1700398690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 KENDRICK ESTATES DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302382196",
            "telephone_number": "678-758-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 KENDRICK ESTATES DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302382196",
            "telephone_number": "678-758-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "FELICIA",
        "middle_name": "M",
        "credential": "PCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "000000000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FELICIA",
            "last_name": "BROWN",
            "credential": "PCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Companion in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Adult Companion in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.