| The Northrop Connection, Llc | |
|
702 W Memorial Dr Dallas GA 30132-4122 | |
| (678) 332-7955 | |
| (678) 719-7540 |
| Full Name | The Northrop Connection, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 702 W Memorial Dr, Dallas, Georgia |
| Authorized Official Name and Position | Jessica Austin Northrop (OWNER) |
| Authorized Official Contact | 6783327955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Northrop Connection, Llc 702 W Memorial Dr Dallas GA 30132-4122 Ph: (678) 332-7955 | The Northrop Connection, Llc 702 W Memorial Dr Dallas GA 30132-4122 Ph: (678) 332-7955 |
| NPI Number | 1912398868 |
|---|---|
| Provider Enumeration Date | 02/13/2015 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Medicare PECOS PAC ID | 6800104506 |
|---|---|
| Medicare Enrollment ID | O20150929003498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912398868 | NPI | - | NPPES |
| Provider Name | Jessica A Northrop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497909998 PECOS PAC ID: 1759429061 Enrollment ID: I20140505001746 |
| Provider Name | Louise Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851782965 PECOS PAC ID: 3577866086 Enrollment ID: I20160115001840 |
| Provider Name | Mary Alice Gillingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154817906 PECOS PAC ID: 5496093999 Enrollment ID: I20190207002109 |
| Provider Name | Jordan Lea Goad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457815664 PECOS PAC ID: 9931512191 Enrollment ID: I20210107000042 |
| Provider Name | Juliet C Ihedike |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962768572 PECOS PAC ID: 9335557560 Enrollment ID: I20210428000096 |
| Provider Name | Shialla Deneen Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962078089 PECOS PAC ID: 3476954470 Enrollment ID: I20210629000343 |
| Provider Name | Paula M Dobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790356871 PECOS PAC ID: 1759770936 Enrollment ID: I20211109001777 |
| Provider Name | Menyuan L Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639839863 PECOS PAC ID: 5496141244 Enrollment ID: I20220405001089 |
| Provider Name | Deanna Ruth Dennis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124244983 PECOS PAC ID: 3577909068 Enrollment ID: I20240306003536 |
| Provider Name | Katie Meade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689394058 PECOS PAC ID: 5597101725 Enrollment ID: I20240311002640 |
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