One Stick Medical Academy

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ONE STICK MEDICAL ACADEMY

Practice address

101 Beckett LN Ste 505
Fayetteville, GA 30214-7160

Phone

(912) 661-9261

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Demisha Latrice Johnson, PHLEBOTMIST, PARMED

Title

Owner

Phone

(912) 661-9261

Specialties & licenses 1

Addresses

Other names 1

• One Stick Lab Express Other name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1992320089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 BETHSAIDA RD STE 101-46",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742971",
            "telephone_number": "912-661-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BECKETT LN STE 505",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147160",
            "telephone_number": "912-661-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE STICK MEDICAL ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEMISHA",
        "authorized_official_middle_name": "LATRICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-661-9261",
        "authorized_official_credential": "PHLEBOTMIST, PARMED"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@onestickmedacademy.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 Beckett Ln Ste 505",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302147160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "One Stick Lab Express",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.