Southern Cross at Home LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

FNP/RN173575 Issued in GA

Legal business name

SOUTHERN CROSS AT HOME LLC

Practice address

980 Birmingham Rd
Ste 501-330
Milton, GA 30004-4417

Phone

(770) 317-8244

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Bunker, APRN, FNP-BC, NP-C

Title

Owner - Founder

Phone

(770) 317-8244

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1891238606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BIRMINGHAM RD",
            "address_2": "STE 501-330",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044417",
            "telephone_number": "770-317-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BIRMINGHAM RD",
            "address_2": "STE 501-330",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044417",
            "telephone_number": "770-317-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CROSS AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "BUNKER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER - FOUNDER",
        "authorized_official_telephone_number": "770-317-8244",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, FNP-BC, NP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "FNP/RN173575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Milton, GA
• Providers in Milton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.