Senior Care Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SENIOR CARE PSYCHIATRY, LLC

Practice address

46 Ember Rd
Jesup, GA 31545-3915

Phone

(904) 557-4306

NPI assigned

Nov 19, 2021

Last updated

Nov 19, 2021By 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

Mr. Amanda McNulty, DNP, PMHNP-BC,FNP-BCNPI 1851710685

Title

Owner

Phone

(904) 557-4306

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda McNulty

  • Family Nurse Practitioner
  • Woodbine, GA
  • NPI 1851710685
  NPD Authorized official

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1730846197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 EMBER RD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315453915",
            "telephone_number": "904-557-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 EMBER RD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315453915",
            "telephone_number": "904-557-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-557-4306",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DNP, PMHNP-BC,FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Jesup, GA
• Providers in Jesup, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.