MH 102, PC (NPI# 1720599657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720599657 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Other Organization Name | MH 102, PC AT NCR |
| Practice Address |
864 Spring St Nw Atlanta GA 30308-1007 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 4702375344 |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |
| Authorized Official Name | BEVERLEY RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 8028570400 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | Y |
| Parent Organization Name | MH 102, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| MH 102, PC at NCR | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 1457985590 | Mh 102, PC | Nurse Practitioner | 193 Tilley Dr, South Burlington, VT 05403-4440 | 2020-02-27 |
| 1831723964 | Mh 102, PC | Nurse Practitioner | 1932 Wynnton Rd, Columbus, GA 31999-0001 | 2020-02-27 |
| 1174157218 | Mh 102, PC | Nurse Practitioner | 813 E 68th St Ste B, Savannah, GA 31405-4710 | 2020-02-27 |
| 1457985509 | Mh 102, PC | Nurse Practitioner | 5204 Bernard Dr Ste 300a, Roanoke, VA 24018-4345 | 2020-02-27 |
| 1588298624 | Mh 102, PC | Nurse Practitioner | 817 Botetourt Ct Ste 106, Chesapeake, VA 23320-4886 | 2020-02-27 |
| 1285105171 | Mh 102, PC | Nurse Practitioner | 2322 Blue Stone Hills Dr Ste 260, Harrisonburg, VA 22801-5403 | 2018-12-17 |
| 1811476286 | Mh 102, PC | Nurse Practitioner | 1020 Barrow Industrial Pkwy, Winder, GA 30680-3891 | 2018-08-07 |
| 1689177040 | Mh 102, PC | Nurse Practitioner | 98 Alexandria Pike Ste 52, Warrenton, VA 20186-2849 | 2018-03-13 |
| 1053754275 | Mh 102, PC | Non-Pharmacy Dispensing Site | 5650 Main St, C/o Vcs Health Center, Manchester Center, VT 05255-9711 | 2013-04-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
864 SPRING ST NW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1790398790 | Starr Patrice Dickerson | Nurse Practitioner | 655 Dot Dr, Atlanta, GA 30349-2730 | 2020-08-28 |
| 1265042162 | Habida Elachola | Nurse Practitioner | 2533 Henderson Mill Rd Ne, Atlanta, GA 30345-2135 | 2020-08-05 |
| 1184249815 | Nichelle Osborne | Nurse Practitioner | 5785 Roswell Rd, Atlanta, GA 30328-4903 | 2020-06-09 |
| 1902427149 | Oasis Health Services, LLC | Nurse Practitioner | 6595 Roswell Rd Ste G1255, Atlanta, GA 30328-3152 | 2020-04-28 |
| 1063042927 | Mary Gillon Hall | Nurse Practitioner | 90 La Rue Pl Nw, Atlanta, GA 30327-4075 | 2020-01-20 |
| 1396382321 | Stacey Brinkley | Nurse Practitioner | 3725 Princeton Lakes Pkwy Sw Apt 7304, Atlanta, GA 30331-5564 | 2019-12-10 |
| 1801439401 | Debadrita Mondal | Nurse Practitioner | 180 Jackson St Ne Apt 2506, Atlanta, GA 30312-1373 | 2019-10-26 |
| 1265075170 | Cecile Veronica Maner | Nurse Practitioner | 105 Collier Rd Nw Ste 3040, Atlanta, GA 30309-1733 | 2019-10-23 |
| 1194366567 | Tondalaya K Sanford | Nurse Practitioner | 3119 Fonseca Pass, Atlanta, GA 30349-8140 | 2019-10-07 |
| Find all providers in ATLANTA | ||||
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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.