NISSI FAMILY MEDICINE LLC (NPI# 1083010201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083010201 |
| Entity Type | Organization |
| Organization Name | NISSI FAMILY MEDICINE LLC |
| Practice Address |
1810 Mulkey Rd Suite 105 Austell GA 30106-1151 |
| Practice Telephone | 6785407597 |
| Practice Fax Number | 7706459802 |
| Mailing Telephone | 6785407597 |
| Mailing Fax Number | 7706459802 |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2014-11-16 |
| Authorized Official Name | MARGA NGWANG (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6785407597 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1810 MULKEY RD SUITE 105 |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114928207 | Cascade Radiology Consultants, PC | Radiology | 1810 Mulkey Rd, Ste 103, Austell, GA 30106-1151 | 2005-08-10 |
| 1801434691 | Dartiss M Chevalier | Nurse Practitioner | 1810 Mulkey Rd, Austell, GA 30106-1151 | 2019-12-12 |
| 1831692110 | Anastacia P Modo | Nurse Practitioner | 1810 Mulkey Rd, Austell, GA 30106-1151 | 2018-03-13 |
| 1942740758 | Amanda Manuel | Nurse Practitioner | 1810 Mulkey Rd, Austell, GA 30106-1151 | 2017-02-27 |
| 1669927455 | Kwneshia Lawane Dorsey | Nurse Practitioner | 1810 Mulkey Rd, Austell, GA 30106-1151 | 2016-08-22 |
| 1013309327 | Amber Borders | Nurse Practitioner | 1810 Mulkey Rd, Suite 201, Austell, GA 30106-1151 | 2015-02-23 |
| 1336569524 | Delano St.aubyn Maxam Jr. | Physical Therapist | 1810 Mulkey Rd, Suite 101, Austell, GA 30106-1151 | 2014-04-26 |
| 1871910174 | Allison Leigh Cargal | Nurse Practitioner | 1810 Mulkey Rd, Suite 201, Austell, GA 30106-1151 | 2014-03-25 |
| 1225321235 | Wellstar Medical Group, LLC | Surgery | 1810 Mulkey Rd, Suite 105, Austell, GA 30106-1151 | 2011-05-24 |
| 1467759837 | M. Ramzy Hajmurad, M. D., P.C. | Urology | 1810 Mulkey Rd, Suite 205, Austell, GA 30106-1151 | 2011-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| 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 |
|---|---|---|---|---|
| 1679045736 | Janda' Hill | Family Medicine | 5043 Ceylon Ct, Austell, GA 30106-2632 | 2018-12-28 |
| 1831622984 | Mali Khamissi Sobi | Family Medicine | 4787 Austell Rd, Austell, GA 30106-2001 | 2017-04-05 |
| 1992253322 | Community Holistic Advanced Practice Nurses (chapn) LLC | Family Medicine | 1707 N. Blairs Bridge Road, Austell, GA 30168-5537 | 2016-09-14 |
| 1790093524 | Saadia Ilyas | Family Medicine | 1605 Mulkey Rd Ste 220, Austell, GA 30106-1127 | 2010-09-14 |
| 1588703730 | Arnold Dollar Gaskin | Family Medicine | 1773 Sweetwater St, Austell, GA 30106-3294 | 2007-02-05 |
| 1164569158 | The Baxter Clinic | Family Medicine | 5914 Love St, Austell, GA 30168-4033 | 2007-01-31 |
| 1306907001 | Bonnie P Ellenoff | Family Medicine | 3640 Tramore Pointe Parkway, Sw, Kaiser Permanente West Cobb Medical Center, Austell, GA 30106 | 2006-12-13 |
| 1851486054 | Laura Alyce Makaroff | Family Medicine | 1850 E West Connector, Unit 221, Austell, GA 30106-1246 | 2006-10-04 |
| 1629089354 | Thi Minh Diem Nguyen | Family Medicine | 4426 Austell Rd, Austell, GA 30106-1844 | 2006-08-10 |
| 1538159603 | Thomas Gearhard | Family Medicine | 1790 Mulkey Rd Ste 8a, Austell, GA 30106-1122 | 2005-10-28 |
| Find all providers in AUSTELL | ||||
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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.