Individual provider Active NPI

Genieve Frost-Johnson, NP

  • Adult Health Nurse Practitioner
  • Austell, GA
National Provider Identifier
1801990304
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
165016 Issued in GA
Practice address
1791 Mulkey Road
Suite 101
Austell, GA 30106-1124
Phone
(770) 941-6883
Fax
(701) 941-7196
NPI assigned
Sep 13, 2006
Last updated
Mar 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 165016 GA Primary

Addresses

Primary practice location

1791 Mulkey Road
Suite 101
Austell, GA 30106-1124

Mailing address

1791 Mulkey Road
Suite 101
Austell, GA 30106-1124
Phone (770) 941-6883

Other identifiers 1

IdentifierTypeStateIssuer
477271178BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
165016GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology of Georgia Past Accepting new patients
United Family Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22623/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1801990304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 MULKEY ROAD",
            "address_2": "SUITE 101",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061124",
            "telephone_number": "770-941-6883",
            "fax_number": "770-941-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 MULKEY ROAD",
            "address_2": "SUITE 101",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061124",
            "telephone_number": "770-941-6883",
            "fax_number": "701-941-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST-JOHNSON",
        "first_name": "GENIEVE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "165016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "477271178B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.