EMPOWER PSYCHIATRY & WEIGHT LOSS, LLC (NPI# 1407341522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407341522 |
| Entity Type | Organization |
| Organization Name | EMPOWER PSYCHIATRY & WEIGHT LOSS, LLC |
| Practice Address |
112 Rowe St Ste B Dublin GA 31021 |
| Mailing Address |
112 Rowe St Ste B Dublin GA 31021-5268 |
| Practice Telephone | 4783531350 |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | DR. JACKLINE B NGALAME (SOLE PROVIDER) |
| Authorized Official Telephone | 4783531350 |
| Authorized Official Credential | DNP, NP-C, PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
212748 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN212748 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | LICENSE | RN212748 | 01 |
| Street Address |
112 ROWE ST STE B |
| City | DUBLIN |
| State | GA |
| Zip Code | 31021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
| 1902384811 | Nieka Jackson | Pharmacist | 75 Woodlawn Dr, Apt. C-1, Dublin, GA 31021 | 2018-08-02 |
| 1619462207 | Kara Emily Frost | Speech-Language Pathologist | 1406 Bellevue Rd, Dublin, GA 31021 | 2018-06-26 |
| 1376035410 | Owens Speech Services, LLC | Speech-Language Pathologist | 401 Barfield Court, Dublin, GA 31021 | 2018-06-05 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1801261177 | Jones Community Health Center, LLC | Clinic/Center | 115 Shadow Pond, Dublin, GA 31021 | 2015-12-11 |
| 1508237561 | Cancer Center of Middle Georgia | Specialist | 26 Erin Office Park, Dublin, GA 31021 | 2015-10-15 |
| 1922477249 | Mickey Jackson | Non-emergency Medical Transport (VAN) | 610 John Robinson Tl., Dublin, GA 31021 | 2015-09-16 |
| 1144634999 | Danielle Paige Martin | Student in an Organized Health Care Education/Training Program | 2400 Bellevue Rd., Suite# 29-b, Dublin, GA 31021 | 2014-06-19 |
| Find all providers in zip 31021 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588272033 | Gabriel Jeu | Nurse Practitioner | 4206 Hitching Post Ct, Dublin, OH 43017-1565 | 2020-07-21 |
| 1386186583 | Jennifer Maynard | Nurse Practitioner | 8483 Torwoodlee Ct, Dublin, OH 43017-9739 | 2016-11-06 |
| 1194194001 | Larissa Mehling | Nurse Practitioner | 6455 Post Rd Ste B, Dublin, OH 43016-1225 | 2015-09-21 |
| 1326310517 | Allison Marie Shue | Nurse Practitioner | 7100 San Ramon Rd Apt 170, Dublin, CA 94568-3236 | 2012-02-02 |
| 1942483201 | Christy E Campbell | Nurse Practitioner | 6500 Emerald Pkwy, 100, Dublin, OH 43016-6235 | 2007-12-10 |
| 1952902561 | Elizabeth Katherine Passino | Nurse Practitioner | 299 Cramer Creek Ct, Dublin, OH 43017-2586 | 2020-11-02 |
| 1457979635 | Olivia Scott | Nurse Practitioner | 7625 Hospital Dr, Dublin, OH 43016-9649 | 2020-07-14 |
| 1790328854 | Angela Triona | Nurse Practitioner | 5945 Sawmill Rd Unit B, Dublin, OH 43017-1623 | 2019-10-22 |
| 1154962769 | Rachel Jones | Nurse Practitioner | 6455 Post Rd Ste B, Dublin, OH 43016-1225 | 2019-10-04 |
| 1104477207 | Sarah Nicole Willig | Nurse Practitioner | 7625 Hospital Dr, Dublin, OH 43016-9649 | 2019-09-20 |
| Find all providers in DUBLIN | ||||
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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.