Organization Active NPI

Integrated Health and Wellness Solutions

  • Family Nurse Practitioner
  • Forest Park, GA
National Provider Identifier
1811679269
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
INTEGRATED HEALTH AND WELLNESS SOLUTIONS
Practice address
4146 Jonesboro Rd
Forest Park, GA 30297-1038
Phone
(678) 799-1218
Fax
(770) 264-5181
NPI assigned
Aug 4, 2023
Last updated
Dec 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Ms. Melva L Banks, MSN, APRN, FNP-CNPI 1083343487
Title
Owner
Phone
(470) 666-4762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

4146 Jonesboro Rd
Forest Park, GA 30297-1038

Mailing address

1333 Cedar Grove Rd Unit 1136
Conley, GA 30288-2542
Phone (470) 666-4762

Other names 1

  • Integrated Health and Wellness Solutions Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231212003570 GA Part B Supplier - Clinic/Group Practice 7113376435 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Park, GA

National Provider Directory

National Provider Directory

Locations

1333 Cedar Grove Rd
Unit 1136
Conley, GA 30288

4146 Jonesboro Rd
Forest Park, GA 30297
Phone (404) 361-2469

149 S McDonough St
Ste 203
Jonesboro, GA 30236

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1811679269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 CEDAR GROVE RD UNIT 1136",
            "city": "CONLEY",
            "state": "GA",
            "postal_code": "302882542",
            "telephone_number": "470-666-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4146 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971038",
            "telephone_number": "678-799-1218",
            "fax_number": "770-264-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH AND WELLNESS SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "MELVA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-666-4762",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Health and Wellness Solutions",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Integrated Health and Wellness Solutions",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Forest Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.