NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC (NPI# 1144719311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144719311 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC |
| Practice Address |
1240 Jesse Jewell Pkwy Se Ste 500 Gainesville GA 30501-3861 |
| Mailing Address |
1100 Johnson Fy Rd Ne Ste 780 Atlanta GA 30342-1743 |
| Practice Telephone | 7705369864 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-10-04 |
| Authorized Official Name | JORGE J HERNANDEZ (VP ADMIN SRVS./CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174005847 | Northeast Georgia Diagnostic Associates and Clinic, LLC | Durable Medical Equipment & Medical Supplies | 1240 Jesse Jewell Pkwy Se Ste 600, Gainesville, GA 30501-3863 | 2018-08-30 |
| Street Address |
1240 JESSE JEWELL PKWY SE STE 500 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568413060 | Santhi P Chennareddy | Family Medicine | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501-3861 | 2006-05-12 |
| 1356634265 | Deep Shikha | Internal Medicine | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501-3861 | 2011-05-25 |
| 1356633499 | Alexander Polsinelli | Physician Assistant | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501-3861 | 2011-05-09 |
| 1093005852 | Vivek Sunny Sambhara | Internal Medicine | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501-3861 | 2011-04-13 |
| 1043519671 | Melissa Davis Summerlin | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501-3861 | 2011-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609190941 | Independent Physical Therapy of Ga LLC | Clinic/Center | 3319 Thompson Bridge Rd, Gainesville, GA 30506-1507 | 2010-03-16 |
| 1558595223 | Shands/solantic Joint Venture, LLC | Clinic/Center | 720 Sw 2nd Ave., 160a, Gainesville, FL 32601 | 2009-05-11 |
| 1174790778 | Professional Therapy Services, LLC | Clinic/Center | 655 Jesse Jewel Pkwy Ste C, Gainesville, GA 30501-3854 | 2008-05-13 |
| 1295248656 | Gainesville Hospital District | Clinic/Center | 1627 N Grand Ave, Gainesville, TX 76240-2343 | 2017-11-08 |
| 1306013941 | Independent Physical Therapy of Ga, LLC | Clinic/Center | 1100 Sherwood Park Dr Ne Ste 140, Gainesville, GA 30501-3426 | 2008-05-13 |
| 1215976634 | Northeast Georgia Diagnostic Clinic LLC | Clinic/Center | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768296 | Ga Diagnostic Providers | Clinic/Center | 5400 Riverside Dr Ste 202, Macon, GA 31210-0818 | 2020-10-22 |
| 1427656156 | Aes International, LLC | Clinic/Center | 6380 Bells Ferry Rd Ste 101, Acworth, GA 30102-5435 | 2020-10-14 |
| 1861000598 | Apple Educational Consulting, Inc. | Clinic/Center | 6225 Atlanta Hwy Ste 110, Alpharetta, GA 30004-8799 | 2020-07-20 |
| 1285242024 | Vernu 2 Inc | Clinic/Center | 501 S Main St Ste 201, Alpharetta, GA 30009-1975 | 2020-07-17 |
| 1598373755 | Pediatric Developmental Services | Clinic/Center | 2250 N Druid Hills Rd Ne Ste 265, Atlanta, GA 30329-3141 | 2020-07-14 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1366068728 | Wood Health LLC | Clinic/Center | 310 Gold Creek Trl Ste 100, Woodstock, GA 30188-5436 | 2020-06-22 |
| 1790307924 | Cryogen Plus LLC | Clinic/Center | 1039 Grant St Se Bldg A, Atlanta, GA 30315-2014 | 2020-05-11 |
| 1174154496 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 2305 Abutment Rd, Dalton, GA 30721-4881 | 2020-01-27 |
| 1447881768 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 2225 S Hamilton St, Dalton, GA 30721-4975 | 2020-01-27 |
| Find all providers with the same taxonomy | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC.
| 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.