MID PROVIDER INC (NPI# 1962621532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962621532 |
| Entity Type | Organization |
| Organization Name | MID PROVIDER INC |
| Practice Address |
1230 Worthington Hills Dr Roswell GA 30076-1753 |
| Practice Telephone | 4042290274 |
| Practice Fax Number | 7705184026 |
| Mailing Telephone | 4042290274 |
| Mailing Fax Number | 7705184026 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2010-01-05 |
| Authorized Official Name | MRS. PATRICIA J NORRIS (DIRECTOR) |
| Authorized Official Telephone | 4042290274 |
| Authorized Official Credential | GNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN133089 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD RETIERMENT | DD4864 | 01 |
| Street Address |
1230 WORTHINGTON HILLS DR |
| City | ROSWELL |
| State | GA |
| Zip Code | 30076-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1841776689 | Scott Gunter Brunson | Hearing Instrument Specialist | 777 Old Roswell Pl # E100, Roswell, GA 30076 | 2018-07-16 |
| 1861998197 | Daniel B Charek | Clinical Neuropsychologist | 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 | 2018-04-04 |
| 1427575554 | A One Home Care, Inc. | In Home Supportive Care | 1875 Old Alabama Road, Suite 420, Roswell, GA 30076 | 2017-08-29 |
| 1053836023 | Madelon Morgan | Counselor | 555 Sun Valley Dr Bldg F, Roswell, GA 30076 | 2017-08-10 |
| 1245769637 | Family Behavioral Health, LLC | Clinic/Center | 9275 Martin Rd, Roswell, GA 30076 | 2017-06-08 |
| 1093163750 | Ryann Soutar | Counselor | 702 Macy Dr, Roswell, GA 30076 | 2016-06-02 |
| 1447618707 | Concierge Medical Mgmt Group | Contractor | 760 Old Roswell Rd Ste 117, Roswell, GA 30076 | 2016-02-02 |
| 1063877710 | Augustine Young | Community/Behavioral Health | 427 Royal Creek Dr, Roswell, GA 30076 | 2015-12-23 |
| 1710360441 | Currents Massage LLC | Massage Therapist | 760 Old Roswell Road, Suite 230, Roswell, GA 30076 | 2015-06-30 |
| Find all providers in zip 30076 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811460850 | Elaine C Mininger | Nurse Practitioner | 401 Bombay Ln, Roswell, GA 30076-5826 | 2019-01-02 |
| 1285119651 | Jennifer May | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2018-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235746009 | Jummai Folashade Akinrinmade | Nurse Practitioner | 5290 Hidden Valley Ln, Cumming, GA 30028-7024 | 2020-09-25 |
| 1396350997 | Ellen Allen | Nurse Practitioner | 8040 Highway 54, Sharpsburg, GA 30277-2112 | 2020-09-10 |
| 1588277867 | Saleta Anica Brogdon | Nurse Practitioner | 10 Muirfield Dr, Covington, GA 30016-6536 | 2020-08-26 |
| 1043828106 | Shonkeisha Byrd | Nurse Practitioner | 1160 Great River Pkwy, Lawrenceville, GA 30045-7015 | 2020-07-15 |
| 1558982272 | Irene Kamau | Nurse Practitioner | 3605 Glenbarrett Ln Ne, Marietta, GA 30066-8509 | 2020-05-05 |
| 1891324133 | Branette Young | Nurse Practitioner | 1120 Lehavre Ct, Hampton, GA 30228-3022 | 2020-04-08 |
| 1851938559 | Sandra Holloway | Nurse Practitioner | 607 Bethany St, Sparks, GA 31647-7139 | 2019-12-02 |
| 1013550508 | Monica Smart Mills | Nurse Practitioner | 8315 Champion Trl, Fairburn, GA 30213-4739 | 2019-10-28 |
| 1063053478 | Emily Elizabeth Adams | Nurse Practitioner | 887 W Marietta St Nw, Atlanta, GA 30318-5252 | 2019-10-07 |
| 1922661800 | Dorcus Healthcare Services LLC | Nurse Practitioner | 105 Greystone Dr, Guyton, GA 31312-5548 | 2019-04-17 |
| 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.