DR. MICHAEL DOUGLAS HELLSTROM (NPI# 1003820259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003820259 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DOUGLAS HELLSTROM |
| Credential | MD |
| Practice Address |
20 Glenlake Pkwy Kaiser Permanente Medical Group Glenlake Atlanta GA 30328 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305-1736 |
| Practice Telephone | 4043650966 |
| Practice Fax Number | 8647167738 |
| Mailing Telephone | 4043647070 |
| Mailing Fax Number | 8647167738 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 67757 | GA | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 16176 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | TL2139 | 05 |
| Street Address |
20 GLENLAKE PKWY KAISER PERMANENTE MEDICAL GROUP GLENLAKE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487655528 | Thomas Wilson Phillips | Radiology | 20 Glenlake Pkwy, Radiation Oncology, Atlanta, GA 30328 | 2005-08-10 |
| 1659998177 | Jamie Elizabeth Coates | Pharmacist | 20 Glenlake Pkwy, Atlanta, GA 30328-3431 | 2020-06-30 |
| 1891335014 | Jenna R Van Zelfden | Nurse Practitioner | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2020-01-15 |
| 1346801362 | Chisom Chijioke Odogwu | Physician Assistant | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2019-06-21 |
| 1790269579 | Lauren Erin Holcomb | Physician Assistant | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2018-09-18 |
| 1528592094 | Kurtis Bertram | Podiatrist | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2017-04-12 |
| 1598111536 | Tiffany Casper | Advanced Practice Midwife | 20 Glenlake Pkwy, Atlanta, GA 30328 | 2016-05-09 |
| 1417343120 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2015-04-09 |
| 1538419726 | James Joseph Weigel | Social Worker | 20 Glenlake Pkwy, Behavioral Health, Atlanta, GA 30328 | 2012-09-14 |
| 1053674903 | Yi-jou Tsai | Psychiatry & Neurology | 20 Glenlake Pkwy, Atlanta, GA 30328-3473 | 2012-06-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
| Find all providers in zip 30328 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376928069 | Wiley A. Parker M.d PC | Otolaryngology | 5669 Peachtree Dunwoody Ste 295, Atlanta, GA 30342-1719 | 2015-07-23 |
| 1730576638 | Mark Arnold | Otolaryngology | 550 Peachtree St Ne Ste 1135550, Atlanta, GA 30308-2247 | 2015-04-20 |
| 1750709770 | Paul Pedram Daraei | Otolaryngology | 6085 Barfield Rd Ste 100, Atlanta, GA 30328-4403 | 2014-04-07 |
| 1588906739 | Zhong Zheng | Otolaryngology | 2061 Peachtree Rd Nw Suite 300, Atlanta, GA 30363 | 2013-03-25 |
| 1932447208 | David Max Cohen | Otolaryngology | 3431 W Paces Ferry Ct Nw, Atlanta, GA 30327-2228 | 2013-01-22 |
| 1669739793 | Lori Michele Guillot | Otolaryngology | 5461 Meridian Mark Rd Ste 130, Atlanta, GA 30342 | 2012-04-13 |
| 1801186192 | Lauren Luk | Otolaryngology | 550 Peachtree St Ne, Suite 1135, Emory University Hospital Midtown, Dept of Otolarngol., Atlanta, GA 30308 | 2011-04-08 |
| 1063567469 | Khuong V Nguyen | Otolaryngology | 4337 Buford Hwy, Ste 200, Atlanta, GA 30341-5044 | 2007-01-24 |
| 1730116161 | Daniel G Carothers | Otolaryngology | 2140 Peachtree Rd Nw Ste 360, Atlanta, GA 30309-1316 | 2006-06-28 |
| 1053348060 | Sarah K Wise | Otolaryngology | Emory Department of Otolaryngology, 1365a Clifton Road Ne, Suite A2300, Atlanta, GA 30322-0001 | 2006-06-26 |
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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.