KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1154437101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154437101 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. |
| Other Organization Name | KAISER PERMANENTE GWINNETT IM |
| Practice Address |
3650 Steve Reynolds Blvd Duluth GA 30096-4506 |
| Practice Telephone | 7709316234 |
| Practice Fax Number | 7709316405 |
| Mailing Telephone | 7709316234 |
| Mailing Fax Number | 7709316405 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2009-11-09 |
| Authorized Official Name | DIANE SANDERS HARVEY (PHCY COMPLIANCE MGR) |
| Authorized Official Telephone | 4049495336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
PHRE007777 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1140968 | 01 |
| Other Name | Type Code |
|---|---|
| KAISER PERMANENTE GWINNETT IM | 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 |
3650 STEVE REYNOLDS BLVD |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-4506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194893 | Barbara Joan Kell | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2005-06-16 |
| 1750906715 | Grace Elizabeth Mason | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2020-06-15 |
| 1881181584 | Cynthia Denise Humenic | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2018-04-18 |
| 1194230540 | Jenna Dannenbaum | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-12-07 |
| 1568994135 | Yolanda Gray-rozier | Registered Nurse | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-04-01 |
| 1306394655 | Carlie Lynne Adams | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-09-15 |
| 1114379757 | Miriam Abouelnasr Gomes | Physician Assistant | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-07-07 |
| 1699158584 | Ann Whitaker | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-09 |
| 1548643968 | Paula Gilman | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-02 |
| 1750763173 | Emily Kim | Internal Medicine | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1568577450 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 | 2006-08-20 |
| 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.