MRS. TERRI TONISHA VAN DORN (NPI# 1124363577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124363577 |
| Entity Type | Individual |
| Full Name | MRS. TERRI TONISHA VAN DORN |
| Other Name | TERRI TONISHA MOORE |
| Credential | NP (ACNP-BC) |
| Practice Address |
1901 Honey Creek Commons Se Conyers GA 30013-5806 |
| Mailing Address |
497 Winn Way Suite A-20 Decatur GA 30030-1712 |
| Practice Telephone | 6784133752 |
| Practice Fax Number | 6784133751 |
| Mailing Telephone | 4042947033 |
| Mailing Fax Number | 4042964661 |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2014-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN195252 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN195252 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN195252 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1901 HONEY CREEK COMMONS SE |
| City | CONYERS |
| State | GA |
| Zip Code | 30013-5806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842295 | Fit Therapy, LLC | Physical Therapist | 2008 Eastview Parkway, Suite 150, Conyers, GA 30013 | 2020-05-12 |
| 1144854753 | Atl Optical LLC | Optometrist | 1285 Ga 138, Conyers, GA 30013 | 2020-02-24 |
| 1386201820 | Achundris P Taylor | Social Worker | Harvest Grove Lane, Conyers, GA 30013 | 2019-05-21 |
| 1588153381 | Curbside Medical Transporters | Ambulance | 2404 Brynlyn Woods Dr Ne, Conyers, GA 30013 | 2018-05-07 |
| 1184124877 | Nursing Companion, LLC | Homemaker | 1064 Duke Dr, Conyers, GA 30013 | 2018-02-19 |
| 1588163638 | Atlanta Plus Urgent Care | Clinic/Center | 2121 Salem Rd. Se, Conyers, GA 30013 | 2018-02-05 |
| 1043735244 | Niki Tanyell Davis | Licensed Practical Nurse | 1403 Windy Hill Court, Conyers, GA 30013 | 2017-08-08 |
| 1063941490 | Comprehensive Health and Rehab LLC | Clinic/Center | 2500 Riverton Drive, Conyers, GA 30013 | 2017-06-08 |
| 1306373188 | Graceol Corporation | Family Medicine | 1035 Honey Creek Rd, Conyers, GA 30013 | 2017-05-11 |
| 1881149268 | Jsa Dental Associates Conyers PC | Dentist | 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 | 2016-08-16 |
| Find all providers in zip 30013 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438530 | Mwiche Williams | Nurse Practitioner | 2337 Deerfield Chase Se, Conyers, GA 30013-6307 | 2020-08-18 |
| 1144790973 | Marlyn M. Wallace | Nurse Practitioner | 3073 Klondike Rd Sw, Conyers, GA 30094-5660 | 2018-12-05 |
| 1174979587 | Taaliba Al-alim Sahib Jr. | Nurse Practitioner | 511 Greenleaf Rd, Conyers, GA 30013-2274 | 2016-05-05 |
| 1679962534 | Rose Gayle-smith | Nurse Practitioner | 2081 Millstone Dr Sw, Conyers, GA 30094-3981 | 2015-01-15 |
| 1700908688 | Angela L. Bright | Nurse Practitioner | 1157 West Ave Sw # B, Conyers, GA 30012-5280 | 2007-04-04 |
| 1104486711 | Tracie Theresa Edwards | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2019-06-17 |
| 1881259703 | Desiree Riley | Nurse Practitioner | 1388 Wellbrook Cir Ne Ste A, Conyers, GA 30012-3872 | 2019-05-06 |
| 1528550068 | Chinyere Chigbu | Nurse Practitioner | 1501 Milstead Rd Ne Ste 110, Conyers, GA 30012-3849 | 2018-05-31 |
| 1093254658 | Taylor Zahn Yengst | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2017-02-15 |
| 1528414943 | Kimberly Anderson | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-05-05 |
| Find all providers in CONYERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.