NPIMap

Organization Active NPI

Populations and Interventions Team Company

  • Health Psychologist
  • Douglasville, GA
National Provider Identifier
1730608522
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
40044 Issued in CA
Legal business name
POPULATIONS AND INTERVENTIONS TEAM COMPANY
Practice address
3182 Berthas Overlook
Douglasville, GA 30135-8458
Phone
(678) 310-9707
Fax
(470) 875-0083
NPI assigned
Sep 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Mercedes Merritt Williams, DBH, MPH, ABVE, CCMNPI 1952820086
Title
Ceo/Owner
Phone
(678) 310-9707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0004X 40044 CA Primary
Prevention ProfessionalGroup: 193200000X MULTI-SPECIALTY GROUP 405300000X 28315 IN

Addresses

Primary practice location

3182 Berthas Overlook
Douglasville, GA 30135-8458

Mailing address

3182 Berthas Overlook
Douglasville, GA 30135-8458
Phone (678) 310-9707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430000730 GA Part B Supplier - Clinic/Group Practice 7113293960 Receives reassigned benefits from 2 practitioners
Practice locations: Douglasville, GA

National Provider Directory

National Provider Directory
Tax ID family
Populations and Interventions Team Company7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1730608522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3182 BERTHAS OVERLOOK",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358458",
            "telephone_number": "678-310-9707",
            "fax_number": "470-875-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3182 BERTHAS OVERLOOK",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358458",
            "telephone_number": "678-310-9707",
            "fax_number": "470-875-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPULATIONS AND INTERVENTIONS TEAM COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_middle_name": "MERRITT",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "678-310-9707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DBH, MPH, ABVE, CCM"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "40044",
            "primary": true
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": "IN",
            "license": "28315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.