Mid Provider Inc

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN133089 Issued in GA

Legal business name

MID PROVIDER INC

Practice address

1230 Worthington Hills Dr
Roswell, GA 30076-1753

Phone

(404) 229-0274

Fax

(770) 518-4026

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia J Norris, GNPNPI 1871512483

Title

Director

Phone

(404) 229-0274

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Jane Norris, APRN

  • Gerontology Nurse Practitioner
  • Huntsville, TX
  • NPI 1871512483
  NPD (past) Authorized official
• Patricia M Norris, APRN, BC

  • Nurse Practitioner
  • Belmont, MA
  • NPI 1144343666
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1962621532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 WORTHINGTON HILLS DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761753",
            "telephone_number": "404-229-0274",
            "fax_number": "770-518-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 WORTHINGTON HILLS DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761753",
            "telephone_number": "404-229-0274",
            "fax_number": "770-518-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID PROVIDER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-229-0274",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "GNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN133089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIERMENT",
            "identifier": "DD4864",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Pitts, Psy.D., P.C.
• Michael W. Shenk D.D.S. P.C. (Shenk Dental Care)
• Maryelle Michael
• Kathleen D Michaud, M.A., L.M.F.T.
• Michele Pond Physical Therapy LLC (PhysioOne)
• Samantha Miehl, RBT
• Stephen E Mikos, M.D.
• Rodothea Milatou, MD
• Miles Connect LLC (Red Apple Interactive Pharmacy)
• Miles Therapy LLC

• Gerontology Nurse Practitioner in Roswell, GA
• Providers in Roswell, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.