TRACIE CHISLOM


Address: 1002 W Solomon St, Griffin, GA 30223-2632
Phone: 6785572613

TRACIE CHISLOM (NPI# 1801354774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801354774
Entity Type Individual
Full Name TRACIE CHISLOM
Practice Address 1002 W Solomon St
Griffin
GA 30223-2632
Practice Telephone 6785572613
Mailing Telephone 6785572613
Enumeration Date 2019-03-08
Last Update Date 2019-03-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA0600X Clinic/Center
Specialization: Adult Day Care
Ambulatory Health Care Facilities

Office Location

Street Address 1002 W SOLOMON ST
City GRIFFIN
State GA
Zip Code 30223-2632

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003431438 Kj Adult Care,llc Clinic/Center 1002 W Solomon St, Griffin, GA 30223-2632 2020-06-11

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235783036 Jennifer Lashawn Stevenson Registered Nurse 1071 Highway 16 West, Griffin, GA 30223 2019-07-30
1992357644 Nikki Petty Behavior Technician 185 Grady Street, Griffin, GA 30223 2019-07-12
1568940146 Brenda Pope Counselor 1710 Highway 16 West, Griffin, GA 30223 2018-08-05
1073025151 Vonita Clowers Specialist 1424 N. Expy, Suite 115, Griffin, GA 30223 2017-10-30
1912427592 Sheena Murphy Registered Nurse 109 N. 10th Street, Griffin, GA 30223 2017-06-23
1033639612 Taralyn Rae Sams Registered Nurse 109 North 10th Street, Griffin, GA 30223 2017-06-23
1326594656 Wendell Robinson Registered Nurse 109 N.10th Street, Griffin, GA 30223 2016-08-28
1508235466 Trenisha Jones Mccall Counselor 1815 North Expressway, Griffin, GA 30223 2015-09-22
1104224948 Dawn Tyus Counselor 424 W. Taylor Street, Griffin, GA 30223 2014-12-10
1003173030 Ingles Markets Inc Pharmacy 1735 Zebulon Rd, Griffin, GA 30223 2012-04-16
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Taxonomy Information

Taxonomy Code 261QA0600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Day Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003431438 Kj Adult Care,llc Clinic/Center 1002 W Solomon St, Griffin, GA 30223-2632 2020-06-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1609481506 Loving Hands Foundation Incorporated Clinic/Center 206 Union St, Lagrange, GA 30241-3343 2020-09-09
1356962443 Southern Hospitality Adult Day Health Agency LLC Clinic/Center 3349 Northside Dr W, Statesboro, GA 30458-2178 2020-04-30
1497383038 Sheryl Dornblaser Clinic/Center 1180 Mckendree Church Rd Ste 107, Lawrenceville, GA 30043-5207 2020-03-30
1720616386 Rainbow Senior Care Home Inc Clinic/Center 4405 International Blvd Ste B101, Norcross, GA 30093-3013 2020-03-30
1932733201 Perfect Care, Inc Clinic/Center 114 Sullivan Dr, Americus, GA 31709-5534 2020-02-26
1710524483 Norman Graham Clinic/Center 125 Marquis Dr, Fayetteville, GA 30214-1566 2019-12-02
1548802937 Serenity Adult Day Health, Inc Clinic/Center 95 Truman Rd, Hawkinsville, GA 31036-4643 2019-10-17
1134778749 Marietta Seniors Club LLC Clinic/Center 748 Lawrence St Ne, Marietta, GA 30060-2144 2019-09-06
1629626445 Wholecare Wellness LLC Clinic/Center 5390 Peachtree Industrial Blvd Ste 130, Norcross, GA 30071-1566 2019-08-27
1750936498 Sec of Georgia Corp Clinic/Center 5522 New Peachtree Rd Ste 128, Atlanta, GA 30341-2544 2019-08-08
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Competitor

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City GRIFFIN
Zip Code 30223

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Dataset Information

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.

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