Providence Healthcare of Georgia

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

PROVIDENCE HEALTHCARE OF GEORGIA

Doing business as

PHG Healthcare

Practice address

6509 Bennington Bluff CT
Mableton, GA 30126-7269

Phone

(404) 408-8703

NPI assigned

Jan 24, 2020

Last updated

Sep 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Neiya Speller

Title

Administrator

Phone

(631) 678-6889

Specialties & licenses 6

Addresses

Other names 1

• PHG Healthcare Doing business as

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1720618077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 BENNINGTON BLUFF CT",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6509 BENNINGTON BLUFF CT",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267269",
            "telephone_number": "404-408-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTHCARE OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "SPELLER",
        "authorized_official_first_name": "NEIYA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-678-6889"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHG Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Registered Nurse in Mableton, GA
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• Home Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.