Mulembet Gorfu, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

186240 Issued in GA

Practice address

2300 West Park Place Blvd.
Suite 135
Stone Mountain, GA 30087-3561

Phone

(678) 330-1400

Fax

(678) 330-1405

NPI assigned

Mar 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Potter'S House Family and Children Treatment Center

  • Adolescent and Children Mental Health Clinic/Center
  • Stone Mountain, GA
  • NPI 1326230020
  NPD (past)

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1740606458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WEST PARK PLACE BLVD.",
            "address_2": "SUITE 135",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873561",
            "telephone_number": "678-330-1400",
            "fax_number": "678-330-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WEST PARK PLACE BLVD.",
            "address_2": "SUITE 135",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873561",
            "telephone_number": "678-330-1400",
            "fax_number": "678-330-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORFU",
        "first_name": "MULEMBET",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "186240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GM Accident and Injury Urgent Care
• Godel First Medical Clinics Inc.
• Nichelle Gooden
• Cierra Goodwin
• Rondine O Gordon, RN
• Fred Dexter Gose, MD
• Sandeep D Goswami, NP
• Edward Marvin Gotlieb, MD
• Jaquelin Smith Gotlieb, MD
• Grace Medical Institute

• All providers in Stone Mountain, GA
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.