JUSTIN VASSELL (NPI# 1114575859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114575859 |
| Entity Type | Individual |
| Full Name | JUSTIN VASSELL |
| Practice Address |
1903 Phoenix Boulevard Suite 200 College Park GA 30349 |
| Mailing Address |
1903 Phoenix Blvd Ste 200 College Park GA 30349-5700 |
| Practice Telephone | 6783359010 |
| Practice Fax Number | 6782299906 |
| Mailing Telephone | 6783359010 |
| Mailing Fax Number | 6782299906 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN169074 | GA | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | PSYCHIATRY | 1881848174 | 01 |
| Street Address |
1903 PHOENIX BOULEVARD SUITE 200 |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| 1144619586 | Catina Hart | Social Worker | 5737 Old National Highway, Suite 300, Atlanta, GA 30349 | 2015-01-22 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598380651 | Elizabeth M White | Registered Nurse | 1919 John Wesley Ave, College Park, GA 30337-3605 | 2020-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744717 | Leighana Caldwell | Registered Nurse | 4104 Springridge Ct, Powder Springs, GA 30127-3546 | 2020-06-10 |
| 1083236087 | Adenike Anne Apata | Registered Nurse | 3796 Okefenokee Rdg, Loganville, GA 30052-7167 | 2020-05-12 |
| 1780233452 | Kellie Tedisco | Registered Nurse | 129 Kelly Farm Dr, Luthersville, GA 30251-1607 | 2019-09-05 |
| 1871053819 | Gay Nell Robinson | Registered Nurse | 733 Erika Ln, Grovetown, GA 30813-8305 | 2019-03-25 |
| 1184123812 | Alex Whitman Peterson | Registered Nurse | 1010 Huntcliff Ste 1350, Atlanta, GA 30350-1809 | 2018-02-08 |
| 1629586748 | Dianne Marie Knettel | Registered Nurse | 37 Calumet Pkwy Ste 100, Newnan, GA 30263-6734 | 2018-01-11 |
| 1205347630 | Caroline R Mckinnon | Registered Nurse | 688 Lambeth Dr, Evans, GA 30809-4272 | 2017-10-12 |
| 1619499357 | Orchid Archer | Registered Nurse | 702 Riverbend Drive, Martinez, GA 30907 | 2017-07-14 |
| 1407381817 | Divine Psychiatric Care | Registered Nurse | 2651 Cedar Dr, Lawrenceville, GA 30043-1325 | 2017-04-23 |
| 1992157671 | Carol J Strickland | Registered Nurse | 637 Sycamore St, Swainsboro, GA 30401-5542 | 2016-07-06 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
Please comment or provide details below to improve the information on JUSTIN VASSELL.
| 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.