LEQUAWN MONTRELL JAMES (NPI# 1154834406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154834406 |
| Entity Type | Individual |
| Full Name | LEQUAWN MONTRELL JAMES |
| Practice Address |
277 Medical Way Riverdale GA 30274 |
| Mailing Address |
600 Phipps Blvd Ne Apt 1601 Atlanta GA 30326-3345 |
| Practice Telephone | 3477351504 |
| Mailing Telephone | 8033944993 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
95137485 | CA | Nursing Service Providers |
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
236509 | GA | Nursing Service Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
95137485 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
236509 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 491 Lindbergh Pl Ne Apt 604, Atlanta, GA 303243336 | 8033944993 | |
| 100 Governors Trce # 109-110, Peachtree City, GA 302694856 | 8332971254 |
| Street Address |
277 MEDICAL WAY |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184162091 | Fellowship Assisted Living LLC | Assisted Living Facility | 277 Medical Way, Riverdale, GA 30274-2522 | 2017-02-10 |
| 1033694864 | Atlanta Detox Center, LLC | Substance Abuse Rehabilitation Facility | 277 Medical Way, Riverdale, GA 30274-2522 | 2018-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528163540 | Imelda Tividad Russell | Nurse Practitioner | 6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737-1346 | 2006-09-14 |
| 1386127751 | Russell & Genc Health and Wellness Center Corporation | Nurse Practitioner | 6510 Kenilworth Ave Ste 2500, Riverdale, MD 20737-1346 | 2018-09-12 |
| 1700368404 | Julie Kim | Nurse Practitioner | 44 State Rt 23 Ste 7, Riverdale, NJ 07457 | 2018-08-30 |
| 1982940797 | Vickie H Browne | Nurse Practitioner | 34 Upper Riverdale Road, Suite 201, Riverdale, GA 30274 | 2012-12-26 |
| 1366760571 | Marian Kolb Jones | Nurse Practitioner | 5711 Sarvis Ave, Suite 200, Riverdale, MD 20737-1394 | 2010-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1427657113 | Cynthia Diane Prather | Nurse Practitioner | 3264 Lower Boston Rd, Thomasville, GA 31757-1311 | 2020-10-22 |
| 1932706728 | Alecia Ann Czarnecki | Nurse Practitioner | 6240 Crooked Creek Dr, Rex, GA 30273-5006 | 2020-10-05 |
| 1801401112 | Cotenna D. Clark | Nurse Practitioner | 1857 Cameo Ct, Tucker, GA 30084-7002 | 2020-09-14 |
| 1487264370 | Helen Young Yates | Nurse Practitioner | 40 Red Rock Ct Ne, Ludowici, GA 31316-6280 | 2020-08-05 |
| 1982214334 | Jasmine Alecia Henderson | Nurse Practitioner | 52 Roseberry Cir, Port Wentworth, GA 31407-5612 | 2020-07-31 |
| 1275142994 | Theresia Richardson | Nurse Practitioner | 2033 Buford Hwy Ste 109, Buford, GA 30518-8802 | 2020-07-28 |
| 1063021277 | Elsa Duncan Duncan | Nurse Practitioner | 1822 E Gwinnett St, Savannah, GA 31404-1853 | 2020-07-24 |
| 1154941946 | Joy P Wharton | Nurse Practitioner | 182 Silver Arrow Cir, Austell, GA 30168-7490 | 2020-04-21 |
| 1235769985 | Michelle Brack | Nurse Practitioner | 502 Hall Rd, Thomasville, GA 31757-8105 | 2020-01-22 |
| 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.