ID GROUP OF ATLANTA (NPI# 1063833267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063833267 |
| Entity Type | Organization |
| Organization Name | ID GROUP OF ATLANTA |
| Practice Address |
735 Piedmont Avenue, Ne Atlanta GA 30308 |
| Practice Telephone | 4045884680 |
| Mailing Telephone | 4045884680 |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2013-12-16 |
| Authorized Official Name | JOHN P OUDERKIRK (MEMBER) |
| Authorized Official Telephone | 4045884680 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 049992 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000926318A | 05 |
| Street Address |
735 PIEDMONT AVENUE, NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225686991 | Ankle and Foot Centers of Georgia, LLC | Non-Pharmacy Dispensing Site | 1819 Peachtree Rd Ne Ste 103, Atlanta, GA 30309-1848 | 2019-08-27 |
| 1124532916 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 3617 Roswell Rd Ne Ste A, Atlanta, GA 30305-1111 | 2017-12-01 |
| 1760876858 | Ehi Pharmacy Solutions, LLC. | Non-Pharmacy Dispensing Site | 2295 Parklake Dr., Ste. 150, Atlanta, GA 30345-2825 | 2015-03-26 |
| 1134539901 | Physicians Care Center of Atlanta | Non-Pharmacy Dispensing Site | 285 Boulevard Ne Ste 435, Atlanta, GA 30312-4213 | 2014-05-02 |
| 1386054088 | Physicians Care Center of Atlanta | Non-Pharmacy Dispensing Site | 315 Boulevard Ne Ste 200, Atlanta, GA 30312-1220 | 2014-05-02 |
| 1225473564 | Jencare Neighborhood Medical Center Druid Hills, LLC | Non-Pharmacy Dispensing Site | 3371 Buford Hwy Ne, Atlanta, GA 30329-1709 | 2013-04-30 |
| 1366783524 | Jencare Neighborhood Medical Center West End, LLC | Non-Pharmacy Dispensing Site | 1325 Ralph David Abernathy Blvd Sw, Atlanta, GA 30310-1649 | 2013-03-12 |
| 1720579188 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 2700 Clairmont Rd Ne, Atlanta, GA 30329-2713 | 2018-05-22 |
| 1295249084 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 2292 Peachtree Rd Nw, Atlanta, GA 30309-1147 | 2017-12-01 |
| 1326552118 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 882 Ponce De Leon Ave Ne, Atlanta, GA 30306-4268 | 2017-12-01 |
| Find all providers in ATLANTA | ||||
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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.