KARINA TAN LYDIA (NPI# 1831659317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831659317 |
Entity Type | Individual |
Full Name | KARINA TAN LYDIA |
Practice Address |
160 Clairemont Ave Ste 445 Decatur GA 30030-2574 |
Practice Telephone | 4045004266 |
Mailing Telephone | 4047122000 |
Enumeration Date | 2019-03-21 |
Last Update Date | 2020-10-02 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | RN242953 | GA | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN242953 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
160 CLAIREMONT AVE STE 445 |
City | DECATUR |
State | GA |
Zip Code | 30030-2574 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548670144 | Yakov Rubinchik | Psychiatry & Neurology | 160 Clairemont Ave Ste 445, Decatur, GA 30030-2574 | 2014-05-05 |
1780176933 | Lindsay Fuson | Nurse Practitioner | 160 Clairemont Ave Ste 445, Decatur, GA 30030-2574 | 2018-06-04 |
1457747503 | James Ragazino | Psychiatry & Neurology | 160 Clairemont Ave Ste 445, Decatur, GA 30030-2574 | 2015-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
Find all providers in zip 30030 |
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 |
---|---|---|---|---|
1851934988 | Tara Michelle Ridgeway | Nurse Practitioner | 2132 E Decatur St, Decatur, IL 62521-3148 | 2019-10-22 |
1245790914 | Faridy Maya Mombeleur | Nurse Practitioner | 2000 S Fm 51 Ste C, Decatur, TX 76234-3702 | 2019-03-20 |
1891204152 | Jasmine Keamber Mckinley | Nurse Practitioner | 1615 Kathy Ln Sw Ste 102, Decatur, AL 35603-1026 | 2017-09-29 |
1700305372 | Jessica Skarda | Nurse Practitioner | 1577-1631 Kathy Ln Sw, Decatur, AL 35603 | 2017-09-14 |
1306477138 | Obiageri Ohayagha | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2020-01-30 |
1407405905 | Erica Y Taylor | Nurse Practitioner | 120 E Trinity Pl, Decatur, GA 30030-3302 | 2019-09-06 |
1205309267 | Ashley M Garner | Nurse Practitioner | 320 E Central Ave, Decatur, IL 62521-4665 | 2019-01-02 |
1801379516 | Lauren Colegrove | Nurse Practitioner | 465 Winn Way Ste 221, Decatur, GA 30030-1723 | 2018-09-09 |
1619459542 | Okechukwu Nnaji | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030-1707 | 2018-09-06 |
1235634635 | Olubukola Funmi Olatoto | Nurse Practitioner | 445 Winn Way, Decatur, GA 30030 | 2018-03-27 |
Find all providers in DECATUR |
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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.