KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1093757809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093757809 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. |
| Other Organization Name | KAISER PERMANENTE GLENLAKE |
| Practice Address |
20 Glenlake Pkwy Ne Atlanta GA 30328-3473 |
| Practice Telephone | 7706776000 |
| Practice Fax Number | 7706777306 |
| Mailing Telephone | 7706776000 |
| Mailing Fax Number | 7706777306 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-11-09 |
| Authorized Official Name | DIANE SANDERS (PHCY COMPLIANCE MGR) |
| Authorized Official Telephone | 4049495336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
PHRE007915 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1136971 | 01 |
| Other Name | Type Code |
|---|---|
| KAISER PERMANENTE GLENLAKE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811321763 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1100 Lake Hearn Dr Ste 500, Atlanta, GA 30342-1548 | 2013-08-28 |
| 1598061608 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 225 Peachtree St Ne Ste C-08, Atlanta, GA 30303-1701 | 2011-02-07 |
| 1174826754 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1478 Dogwood Dr Se, Conyers, GA 30013-5088 | 2010-12-21 |
| 1053612119 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2010-11-05 |
| 1063733210 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2505 Dallas Hwy Sw, Marietta, GA 30064-2659 | 2010-06-22 |
| 1538480553 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2240 Fountain Dr, Snellville, GA 30078-2919 | 2010-06-14 |
| 1881910552 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 | 2010-04-20 |
| 1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
| 1699003681 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 | 2009-12-02 |
| 1447487574 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1400 Northside Forsyth Dr Ste 350, Cumming, GA 30041-6018 | 2009-06-16 |
| Street Address |
20 GLENLAKE PKWY NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328-3473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457319568 | April Michelle Liverman | Physician Assistant | 20 Glenlake Pkwy Ne, Dept of Breast Surgery, Atlanta, GA 30328-3473 | 2006-05-01 |
| 1184911760 | Anuj Ashwin Patel | Pharmacist | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2011-07-05 |
| 1194039115 | Sherry-ann Renee Marshall | Pharmacist | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2010-08-02 |
| 1205152881 | Barry Michael Mason | Urology | 20 Glenlake Pkwy Ne, Urology Department, Atlanta, GA 30328-3473 | 2010-04-08 |
| 1184888497 | John Douglas Edwards Jr. | Radiologic Technologist | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2008-07-16 |
| 1225291859 | Kaiser Foundation Health Plan of Georgia Inc. | Clinical Medical Laboratory | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2008-07-03 |
| 1164692554 | Brian Jaehoon Chung | Otolaryngology | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2008-03-03 |
| 1043400930 | Shahidur Rahman | Pediatrics | 20 Glenlake Pkwy Ne, Glenlake Medical Center, Atlanta, GA 30328-3473 | 2007-07-27 |
| 1831305820 | Vanessa Etheridge Smith | Pharmacist | 20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473 | 2007-05-15 |
| 1669540043 | Jennifer Plunkett | Surgery | 20 Glenlake Pkwy Ne, Department of Surgery, Atlanta, GA 30328-3473 | 2006-12-01 |
| Find all providers in the same location | ||||
| 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 | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| 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 |
|---|---|---|---|---|
| 1568577450 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 | 2006-08-20 |
| 1932141710 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 2006-06-13 |
| 1538275599 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2525 Cumberland Pkwy Se, Atlanta, GA 30339-3915 | 2006-08-22 |
| 1295840189 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2525 Cumberland Pkwy Se, Atlanta, GA 30339-3915 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316465859 | Integrated Health Solutions LLC | Pharmacy | 1284 Glandor Ct Se, Mableton, GA 30126-2755 | 2017-09-05 |
| 1174826754 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1478 Dogwood Dr Se, Conyers, GA 30013-5088 | 2010-12-21 |
| 1053612119 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2010-11-05 |
| 1881910552 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 | 2010-04-20 |
| 1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
| 1699003681 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 | 2009-12-02 |
| 1366622912 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 8011 Mall Pkwy, Lithonia, GA 30038-2543 | 2007-11-13 |
| 1518090836 | Northeast Georgia Health Services | Pharmacy | 825 Jesse Jewell Parkway Suite D, Gainesville, GA 30501-3715 | 2007-03-14 |
| 1578606950 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 | 2007-02-15 |
| 1760790414 | Personal Medication Consulting, P.C. | Pharmacy | 6677 Glenmore Way, Columbus, GA 31904-2466 | 2010-09-15 |
| Find all providers with the same taxonomy | ||||
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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.