Active NPI
Kbsolutions and Behavioral Support Services
- Family Nurse Practitioner
- Conyers, GA
National Provider Identifier
1790397495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | |||
| Family Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003240710A | Medicaid | GA |
Other names 1
- KBS
National Provider Directory
National Provider DirectoryNPI 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.