Comprehensive Vine Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

RN10908 Issued in GA

Legal business name

COMPREHENSIVE VINE HEALTH SERVICES

Practice address

1978 Scarbrough Dr
Stone Mountain, GA 30088-4422

Phone

(404) 796-6511

Fax

(678) 550-9140

NPI assigned

Dec 26, 2011

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Quintina L Macauley, NPNPI 1326352972

Title

Owner

Phone

(404) 796-6511

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 3

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.

• Quintina L Macauley, APRN-BC

  • Family Nurse Practitioner
  • Stone Mountain, GA
  • NPI 1326352972
  Medicare reassignment Care Compare group NPD Authorized official
• Lana Marie Chase, CNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Atlanta, GA
  • NPI 1346441029
  Medicare reassignment Care Compare group NPD
• Nyambura Kuria

  • Psychiatric/Mental Health Nurse Practitioner
  • Ellenwood, GA
  • NPI 1770296725
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1972872661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 SCARBROUGH DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300884422",
            "telephone_number": "404-796-6511",
            "fax_number": "678-550-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 SCARBROUGH DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300884422",
            "telephone_number": "404-796-6511",
            "fax_number": "678-550-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE VINE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-26",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "MACAULEY",
        "authorized_official_first_name": "QUINTINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-796-6511",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "RN109088",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "RN10908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carla N Cooke, PA-C

• Community/Behavioral Health Agency in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.