EAGLES LANDING FAMILY PRACTICE, LLC (NPI# 1073829073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073829073 |
| Entity Type | Organization |
| Organization Name | EAGLES LANDING FAMILY PRACTICE, LLC |
| Practice Address |
2200 Highway 155 N Mcdonough GA 30252-4806 |
| Practice Telephone | 6784900341 |
| Practice Fax Number | 6784900349 |
| Mailing Telephone | 6784900341 |
| Mailing Fax Number | 6784900349 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | JEFF MITCHAM (COO) |
| Authorized Official Telephone | 7709140116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521782 | Eagles Landing Family Practice, LLC | Family Medicine | 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339-3304 | 2020-06-08 |
| 1144483744 | Eagles Landing Family Practice, LLC | Family Medicine | 1101 Nortec Dr Se, Conyers, GA 30013-5835 | 2008-07-03 |
| 1710079850 | Eagles Landing Family Practice, LLC | Family Medicine | 649 Jonesboro Road, Mcdonough, GA 30253 | 2006-09-28 |
| 1902907207 | Eagles Landing Family Practice, LLC | Family Medicine | 62 Kelly Rd, Mcdonough, GA 30253-6012 | 2006-09-26 |
| 1013018811 | Eagles Landing Family Practice, LLC | Family Medicine | 2330 Patrick Henry Pkwy, Suite 200, Mcdonough, GA 30253-4220 | 2006-09-26 |
| 1649623380 | Eagles Landing Family Practice, LLC | Family Medicine | 1240 Eagles Landing Pkwy, Suite 110, Stockbridge, GA 30281-5170 | 2016-07-18 |
| 1154774883 | Eagles Landing Family Practice, LLC | Internal Medicine | 145 Eagles Walk, Stockbridge, GA 30281-7340 | 2016-07-18 |
| 1578827655 | Eagles Landing Family Practice, LLC | Radiology | 1100 Hospital Dr, Stockbridge, GA 30281-6381 | 2012-07-03 |
| 1770744450 | Eagles Landing Family Practice, LLC | Family Medicine | 65 Old Jackson Rd, Mcdonough, GA 30252-3095 | 2008-06-24 |
| 1205919263 | Eagles Landing Family Practice, LLC | Family Medicine | 1502 Highway 16 E, Jackson, GA 30233-5202 | 2006-10-23 |
| Street Address |
2200 HIGHWAY 155 N |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30252-4806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023227030 | Kashif Ahmed | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2007-05-22 |
| 1558900902 | April Gordon | Nurse Practitioner | 2200 Highway 155 N, Mcdonough, GA 30252-4846 | 2020-01-02 |
| 1497222962 | Lyna B Tran | Physician Assistant | 2200 Highway 155 N, Mcdonough, GA 30252-4846 | 2018-11-01 |
| 1154716405 | Priya Gulati Shah | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252 | 2015-04-03 |
| 1639578305 | Amanda Butler | Nurse Practitioner | 2200 Highway 155 N, Mcdonough, GA 30252-4846 | 2014-08-19 |
| 1306107685 | Ashley Blackmon | Nurse Practitioner | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2012-06-04 |
| 1376838706 | Sabine Hurst | Nurse Practitioner | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2011-06-14 |
| 1053602045 | Tse-hwa Johnson Yin | Internal Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4846 | 2011-04-25 |
| 1720309057 | Stacy Michael Olliff | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4846 | 2010-06-22 |
| 1851521140 | Raymond Scott Dickerson | Physician Assistant | 2200 Highway 155 N, Mcdonough, GA 30252 | 2009-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114427 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 3479 Highway 81 East, Mcdonough, GA 30252 | 2020-11-03 |
| 1770143547 | Kevin Kirk Anderson | Physical Therapist | Dr. Kevin Anderson, 196 Lake Dow Rd, Mcdonough, GA 30252 | 2019-06-14 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1194271320 | Christine Williams Breeden | Registered Nurse | 189 Irwin Drive, Mcdonough, GA 30252 | 2016-08-28 |
| 1518322395 | Jaquita Shorts | Counselor | 1705 Pennslyvania Ave, Mcdonough, GA 30252 | 2015-12-22 |
| 1356758973 | Keisha Candies | Counselor | 125 Zack Hinton Pkwy, Mcdonough, GA 30252 | 2014-07-15 |
| 1093145666 | Ceisha Shador Parks | Counselor | 6040 Winston Trace, Mcdonough, GA 30252 | 2013-11-19 |
| 1588939565 | Tasha E Jones | Counselor | 1509 Bent River Cir, Mcdonough, GA 30252 | 2012-03-09 |
| 1598049447 | Proactive Rehab, Inc | Physical Therapist | 50 Lawrenceville Street, Suite 100, Mcdonough, GA 30252 | 2011-10-10 |
| 1164706131 | Michelle Lee Cone | Pharmacist | 1210 Bent Creek Dr, Mcdonough, GA 30252 | 2011-10-07 |
| Find all providers in zip 30252 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679908503 | Kashif Ahmed Md LLC | Family Medicine | 336 Langshire Dr, Mcdonough, GA 30253-8055 | 2013-09-11 |
| 1699912113 | Reliance Family Care | Family Medicine | 345 Huntington Place Ct, Mcdonough, GA 30253-8651 | 2009-01-21 |
| 1356526305 | Heritage Medical Group, PC | Family Medicine | 1010 Pennsylvania Avenue, Heritage Medical Group, PC, Mcdonough, GA 30253 | 2008-01-08 |
| 1023227030 | Kashif Ahmed | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2007-05-22 |
| 1710058953 | Mcdonough Primary Care Inc | Family Medicine | 68 Hampton St, Mcdonough, GA 30253-3150 | 2006-11-10 |
| 1194809269 | Kevin Michael Kurey | Family Medicine | 101 Regency Park Drive, Suite 130, Mcdonough, GA 30253 | 2006-10-25 |
| 1710079850 | Eagles Landing Family Practice, LLC | Family Medicine | 649 Jonesboro Road, Mcdonough, GA 30253 | 2006-09-28 |
| 1902907207 | Eagles Landing Family Practice, LLC | Family Medicine | 62 Kelly Rd, Mcdonough, GA 30253-6012 | 2006-09-26 |
| 1013018811 | Eagles Landing Family Practice, LLC | Family Medicine | 2330 Patrick Henry Pkwy, Suite 200, Mcdonough, GA 30253-4220 | 2006-09-26 |
| 1922019850 | Walnut Creek Family Practice, P.C. | Family Medicine | 4303 Jodeco Rd, Mcdonough, GA 30253-8297 | 2006-08-09 |
| Find all providers in MCDONOUGH | ||||
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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.