MS. MARY VIRGINIA ACKLIN (NPI# 1629082524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629082524 |
| Entity Type | Individual |
| Full Name | MS. MARY VIRGINIA ACKLIN |
| Credential | CPNP |
| Practice Address |
30 Warren St Se Dekalb Grady Clinic Atlanta GA 30317-2267 |
| Practice Telephone | 4046169304 |
| Practice Fax Number | 4043779324 |
| Mailing Telephone | 4046169304 |
| Mailing Fax Number | 4043779324 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN034948 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
30 WARREN ST SE DEKALB GRADY CLINIC |
| City | ATLANTA |
| State | GA |
| Zip Code | 30317-2267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790946325 | Yolanda Washington Tapp | Registered Nurse | 30 Warren St Se, Atlanta, GA 30317-2267 | 2008-06-17 |
| 1942417480 | Andre Shinabarger | Physician Assistant | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-05-16 |
| 1730305004 | Meridian Education Resource Group, Inc. | Clinic/Center | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-04-17 |
| 1437271095 | Carolyn W Brewster | Registered Nurse | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-04-04 |
| 1790806016 | Sherri Arnise Okpodu | Registered Nurse | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-04-03 |
| 1699809970 | Samuel W. Dooley Jr. | Internal Medicine | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-03-16 |
| 1891829883 | Henry Slater Kahn | Internal Medicine | 30 Warren St Se, Dekalb Grady Neighborhood Health Center, Atlanta, GA 30317-2267 | 2007-03-14 |
| 1508912809 | Weigong Zhou | Family Medicine | 30 Warren St Se, Atlanta, GA 30317-2267 | 2007-01-27 |
| 1396809216 | Betty Neal | Registered Nurse | 30 Warren St Se, Atlanta, GA 30317-2267 | 2006-12-22 |
| 1659433696 | Amina Porter | Counselor | 30 Warren St Se, Atlanta, GA 30317-2267 | 2006-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391395 | Tara Lozano Thrutchley | Counselor | 2033 Hosea L Williams Drive Ne, Suite 2, Atlanta, GA 30317 | 2019-11-26 |
| 1689052326 | Pharmworks Group LLC | Pharmacy | 1860 Memorial Dr Se, Atlanta, GA 30317 | 2015-05-14 |
| 1891032157 | Carla Bernita Jones | Licensed Practical Nurse | 2064 Ridgedale Rd Ne, Atlanta, GA 30317 | 2013-01-07 |
| 1154428985 | Dekalb County Board of Health | Public Health or Welfare | 2006 Hosea Williams Dr., Atlanta, GA 30317 | 2006-09-20 |
| 1548228034 | Yuri Okuizumi Wu | Pediatrics | 35 Whitefoord Ave Se, Atlanta, GA 30317 | 2006-05-03 |
| 1093052359 | Third Day Ministry | Religious Nonmedical Practitioner | 2064 Ridgedale Rd Ne, Atlanta, GA 30317 | 2013-01-07 |
| 1548215254 | Adrian Gendell Bonser | Dentist | 30 Warren St, Atlanta, GA 30317 | 2006-05-23 |
| 1245284041 | Magdy Attia | Dentist | 30 Warren St, Atlanta, GA 30317 | 2006-05-19 |
| 1245845288 | Jennie Gray Mulligan | Social Worker | 1911 Hallman St Ne, Atlanta, GA 30317-1001 | 2020-09-15 |
| 1942837125 | Kathryn Caracappa Boulet | Counselor | 1942 Delano Dr Ne, Atlanta, GA 30317-1009 | 2020-03-26 |
| Find all providers in zip 30317 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565811 | Rebecca Danielle Wegman | Nurse Practitioner | 5445 Meridian Mark Rd Ste 380, Atlanta, GA 30342-4755 | 2020-10-09 |
| 1629675657 | Casey Cullins | Nurse Practitioner | 980 Johnson Fy Rd Ne Ste 680, Atlanta, GA 30342-1608 | 2020-10-02 |
| 1538798095 | Brittany Nicole Heitkamp | Nurse Practitioner | 5461 Meridian Mark Rd Ste 540, Atlanta, GA 30342-3283 | 2020-04-06 |
| 1093342131 | Lindsay Pare | Nurse Practitioner | 2225 Twin Lakes Dr, Atlanta, GA 30339-4123 | 2020-03-26 |
| 1487290581 | Fawn Aryana Hastay | Nurse Practitioner | 1400 Tullie Rd Ne Fl 6, Atlanta, GA 30329-2309 | 2019-11-23 |
| 1245798057 | Rebecca Emory | Nurse Practitioner | 975 Johnson Ferry Rd Ste 340, Atlanta, GA 30342-4735 | 2019-03-11 |
| 1497265904 | Stephanie Edlhuber | Nurse Practitioner | 1100 Lake Hearn Dr Ste 100, Atlanta, GA 30342-1524 | 2017-10-10 |
| 1275074924 | Anna Louise Kelly | Nurse Practitioner | 993 Johnson Ferry Rd # 440, Atlanta, GA 30342-1620 | 2017-03-14 |
| 1518410984 | Brie Batchelor Baxter | Nurse Practitioner | 5461 Meridian Marks Rd, Suite 200, Atlanta, GA 30342 | 2016-08-02 |
| 1649630310 | Mary Bertossi | Nurse Practitioner | 1800 Howell Mill Rd Nw Ste 475, Atlanta, GA 30318-0920 | 2016-02-24 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on MS. MARY VIRGINIA ACKLIN.
| 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.