MH 102, PC (NPI# 1811476286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811476286 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Other Organization Name | MH 102, PC AT CHICO'S WINDER GA |
| Practice Address |
1020 Barrow Industrial Pkwy Winder GA 30680-3891 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 8028570400 |
| Mailing Telephone | 8028570400 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |
| Authorized Official Name | BEVERLEY RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 8028570400 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | MH 102, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| MH 102, PC at Chico's Winder GA | 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 |
| 1689177040 | Mh 102, PC | Nurse Practitioner | 98 Alexandria Pike Ste 52, Warrenton, VA 20186-2849 | 2018-03-13 |
| 1720599657 | Mh 102, PC | Nurse Practitioner | 864 Spring St Nw, Atlanta, GA 30308-1007 | 2017-10-18 |
| 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 |
1020 BARROW INDUSTRIAL PKWY |
| City | WINDER |
| State | GA |
| Zip Code | 30680-3891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326520776 | Alexandrea Hosch | Specialist/Technologist | 474 Lisa Circle, Winder, GA 30680 | 2018-09-02 |
| 1427574185 | Kristen Layfield Harbin | Dietitian, Registered | 827 Jefferson Hwy, Winder, GA 30680 | 2017-08-15 |
| 1417485715 | Staci Harwell Tebbetts | Optometrist | 279 N Broad St Ste C, Winder, GA 30680 | 2017-05-31 |
| 1609234947 | Carmichaels Home Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 289 N Broad St, Winder, GA 30680 | 2016-02-02 |
| 1699140434 | Chee Vang | Physical Therapy Assistant | 1012 Bowman Way, Winder, GA 30680 | 2015-12-04 |
| 1518361989 | Usrc Winder, LLC | Clinic/Center | 429 Loganville Hwy Ste 105-109, Winder, GA 30680 | 2014-10-14 |
| 1871901090 | Carol Lumpkin | Nurse Practitioner | 15 Porter St East, Winder, GA 30680 | 2014-07-31 |
| 1548501851 | Jennifer Won | Dentist | 444 Atlanta Hwy Nw Ste 500, Winder, GA 30680 | 2013-03-12 |
| 1801041595 | Joan Theresa James | Obstetrics & Gynecology | 137 W Athens St Ste 103, Winder, GA 30680 | 2008-11-21 |
| 1669636767 | Lee Lindsey Bleshoy | Nurse Practitioner | 133 W Athens St Ste A, Winder, GA 30680 | 2008-07-17 |
| Find all providers in zip 30680 | ||||
| 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 |
|---|---|---|---|---|
| 1639253164 | Poppy M Tansey | Nurse Practitioner | 316 N Broad St, Winder, GA 30680-2150 | 2006-10-24 |
| 1619080199 | Patricia Dew | Nurse Practitioner | 316 N Broad St, Winder, GA 30680-2150 | 2006-08-17 |
| 1598715104 | Gail Weaver | Nurse Practitioner | 316 N Broad St, Winder, GA 30680-2187 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841186 | Cynthia Marie Benjamin Bates | Nurse Practitioner | 2746 Willis Foreman Rd, Hephzibah, GA 30815-6935 | 2020-11-06 |
| 1841891199 | Gloria Oduro | Nurse Practitioner | 983 Bentley Estates Dr, Dacula, GA 30019-7795 | 2020-11-03 |
| 1689274094 | Shundria Brown | Nurse Practitioner | 2122 Ellwyn Dr, Chamblee, GA 30341-1520 | 2020-10-27 |
| 1629677455 | Amy Lynn Patterson | Nurse Practitioner | 254 Senna St, Marietta, GA 30064-4417 | 2020-10-22 |
| 1538768965 | Tabitha Ford | Nurse Practitioner | 110 Shorter St Lot 9, Ty Ty, GA 31795-3179 | 2020-10-16 |
| 1902404320 | Shanelle Lynette Raiford | Nurse Practitioner | 2028 Hidden Meadow Ln, Stone Mountain, GA 30088-4448 | 2020-10-16 |
| 1760089072 | Diana Maresi Bulimu | Nurse Practitioner | 6050 Peachtree Pkwy # 240-178, Norcross, GA 30092-3336 | 2020-10-08 |
| 1760089692 | Natalie Xiomara Leak | Nurse Practitioner | 4855 Chesterfield Ct, Suwanee, GA 30024-1350 | 2020-10-05 |
| 1548877723 | Camille Watson-clarke | Nurse Practitioner | 3650 Steve Reynolds Blvd Ste 316, Duluth, GA 30096-4506 | 2020-09-30 |
| 1801403654 | Jacqueline Richart | Nurse Practitioner | 6300 Hospital Pkwy Ste 260, Johns Creek, GA 30097-1829 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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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.