SNELLVILLE PRIMARY CARE (NPI# 1104033315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104033315 |
| Entity Type | Organization |
| Organization Name | SNELLVILLE PRIMARY CARE |
| Practice Address |
1800 Tree Ln Ste 290a Snellville GA 30078-2016 |
| Practice Telephone | 7709791544 |
| Practice Fax Number | 7709795662 |
| Mailing Telephone | 7709791544 |
| Mailing Fax Number | 7709795662 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SARAH GHAYOURI (DOCTOR - OWNER) |
| Authorized Official Telephone | 7709791544 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207Q00000X | Family Medicine | 017573 | GA | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | 039109 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00623389A | 05 |
| Street Address |
1800 TREE LN STE 290A |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078-2016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881689115 | Janice C Lim | Family Medicine | 1800 Tree Ln, Suite 120, Snellville, GA 30078-2016 | 2005-09-13 |
| 1518343060 | Lauren Alesch | Physical Therapist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2015-08-07 |
| 1023493558 | Kendra Gardner | Specialist/Technologist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2015-07-27 |
| 1598176406 | Air Evac Ems Inc. | Ambulance | 1800 Tree Ln, Snellville, GA 30078-2016 | 2014-05-13 |
| 1851717201 | Sarah Ritchie | Physical Therapist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2014-03-10 |
| 1518399468 | Kyle E Fenton | Physical Therapist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2013-08-02 |
| 1912258088 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 1800 Tree Ln, Eastside Physician Plaza, Snellville, GA 30078-2016 | 2012-09-28 |
| 1811298896 | Dustin M Tate | Specialist/Technologist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2010-11-08 |
| 1134434467 | Gwinnett Orthopedics PC | Specialist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2010-08-11 |
| 1952531626 | Andrew D Balick | Specialist/Technologist | 1800 Tree Ln, Suite 140, Snellville, GA 30078-2016 | 2009-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| 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 |
|---|---|---|---|---|
| 1487139184 | Lorraine A Smith | Family Medicine | 3121 Grundy Ives Dr, Snellville, GA 30039-3610 | 2018-09-27 |
| 1720569403 | Phoenix Clinic and Afterhour Care | Family Medicine | 2795 Main St W # 21, Snellville, GA 30078-3164 | 2018-08-22 |
| 1649766791 | Peachtree Immediate Care Fp, LLC | Family Medicine | 3991 Highway 78 W Ste 100, Snellville, GA 30039-3929 | 2018-07-02 |
| 1871947176 | Amita Dilip Nawathe | Family Medicine | 1790 Presidential Cir Ste C, Snellville, GA 30078-5688 | 2016-04-22 |
| 1457602989 | Crosslinks Family Practice & Rehab., LLC | Family Medicine | 3300 Centerville Hwy, Ste 1301, Snellville, GA 30039-5994 | 2012-09-24 |
| 1982720827 | Amira M Elsayed | Family Medicine | 2835 Centerville Hwy Bldg 1, Snellville, GA 30078-4503 | 2007-03-22 |
| 1710094644 | Hugh Malcolm Dejarnette Jr. | Family Medicine | 1550 Janmar Rd # B, Snellville, GA 30078-5600 | 2006-08-24 |
| 1164452942 | Yong S Kim | Family Medicine | 1742 Oak Rd, Snellville, GA 30078-2234 | 2006-07-04 |
| 1083652267 | Gordon Glenn Freeman | Family Medicine | 3891 Highway 78 W, Snellville, GA 30039-3932 | 2006-06-02 |
| 1639133846 | Rashmi Sinha | Family Medicine | 1608 Tree Lane Rd, Building C, Snellville, GA 30078-2399 | 2006-04-14 |
| Find all providers in SNELLVILLE | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
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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.