Organization Active NPI

Kbsolutions and Behavioral Support Services

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1790397495
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
KBSOLUTIONS AND BEHAVIORAL SUPPORT SERVICES
Practice address
1775 Parker Rd SE Ste 210
Conyers, GA 30094-6654
Phone
(770) 376-7927
NPI assigned
Aug 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Laquanda T Spince, FNP
Title
Owner/Nurse Practitioner
Phone
(770) 376-7927

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1775 Parker Rd SE Ste 210
Conyers, GA 30094-6654

Mailing address

950 Eagles Landing Pkwy Ste 146
Stockbridge, GA 30281-7343

Other identifiers 1

IdentifierTypeStateIssuer
003240710AMedicaidGA

Other names 1

  • KBS Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1790397495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 EAGLES LANDING PKWY STE 146",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 PARKER RD SE STE 210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946654",
            "telephone_number": "770-376-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KBSOLUTIONS AND BEHAVIORAL SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "SPINCE",
        "authorized_official_first_name": "LAQUANDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "770-376-7927",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003240710A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KBS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "KBS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.