Active NPI
Mildred Grant, RN
- Psychiatric Hospital
- Sumner, GA
National Provider Identifier
1922485804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 159125
- Practice address
- 255 Sumner Lakes Rd
Sumner, GA 31789-4431 - Phone
- (229) 288-2185
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 159125 | GA | Primary |
Addresses
Primary practice location
255 Sumner Lakes Rd
Sumner, GA 31789-4431
Mailing address
255 Sumner Lakes Rd
Sumner, GA 31789-4431
Phone (229) 288-2185
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159125 | GA | MD | Psychiatric Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1922485804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 SUMNER LAKES RD",
"city": "SUMNER",
"state": "GA",
"postal_code": "317894431",
"telephone_number": "229-288-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 SUMNER LAKES RD",
"city": "SUMNER",
"state": "GA",
"postal_code": "317894431",
"telephone_number": "229-288-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "MILDRED",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "GA",
"license": "159125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumner, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.