PRACTITONERS COMMUNITY CARE NPI 1043860554

NPI Information

NPI: 1043860554
Provider Name: PRACTITONERS COMMUNITY CARE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
870 CRESTMARK DR STE 200
LITHIA SPRINGS, GA
ZIP 30122
Phone: (770) 374-7062
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PRACTITONERS COMMUNITY CARE is a primary care clinic center in Lithia Springs, GA. PRACTITONERS COMMUNITY CARE NPI is 1043860554. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

870 CRESTMARK DR STE 200
LITHIA SPRINGS, GA
ZIP 30122-665
Phone: (770) 374-7062

The provider's authorized official is Sheila Renee Littles .
The authorized official title is Nurse Practitioner and has the following contact phone number (770) 374-7062.

The enumeration date for this NPI number is 9/17/2019 and was last updated on 7/18/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health			No
2	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q03882281	OTHER	GEORGIA	MEDICARE
2	003227729B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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