ATLANTA MEDICAL CENTER PHYSICIAN GROUP, LLC (NPI# 1235568387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235568387 |
| Entity Type | Organization |
| Organization Name | ATLANTA MEDICAL CENTER PHYSICIAN GROUP, LLC |
| Practice Address |
3886 Redwine Road Suite 160 Atlanta GA 30331 |
| Mailing Address |
303 Parkway Dr Box 427 Atlanta GA 30312-1212 |
| Practice Telephone | 4045303060 |
| Practice Fax Number | 4045303053 |
| Mailing Telephone | 4045303060 |
| Mailing Fax Number | 4045303053 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2016-05-26 |
| Authorized Official Name | MR. WESLEY O. JAMES (REGIONAL CFO, TENET) |
| Authorized Official Telephone | 4042655009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
3886 REDWINE ROAD SUITE 160 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699115451 | Jeffrey Alan Bernstein | Obstetrics & Gynecology | 655 Widgeon Lane, Atlanta, GA 30327 | 2013-06-26 |
| 1871865113 | Candace Marvenia Tillman | Obstetrics & Gynecology | 477 Windsor St. Sw, Ste. 309, Atlanta, GA 30312 | 2012-02-02 |
| 1780904896 | Jana Dopson Illston | Obstetrics & Gynecology | 980 Johnson Fy Rd Ne Ste 720, Atlanta, GA 30342-1628 | 2010-06-11 |
| 1730362732 | Eldred Bernard Taylor | Obstetrics & Gynecology | 5901 Peachtree Dunwoody Rd Ne # C, Suite 25, Atlanta, GA 30328-5382 | 2007-12-12 |
| 1528276904 | Jean V Longley | Obstetrics & Gynecology | 6195 Heards Creek Dr Nw, Atlanta, GA 30328-3653 | 2007-05-18 |
| 1134342744 | Beverly Goode Douglas | Obstetrics & Gynecology | 1046 Lenox Crst Ne, Atlanta, GA 30324-2700 | 2007-04-11 |
| 1669571295 | Lisa Flowers | Obstetrics & Gynecology | 49 Jesse Hill Jr Dr Se Fl 3, Atlanta, GA 30303-3049 | 2006-09-21 |
| 1700801206 | Michael David Randell | Obstetrics & Gynecology | 5667 Peachtree Dunwoody Rd Ste 280, Atlanta, GA 30342-1714 | 2006-07-13 |
| 1346273364 | Carl W Sherrer | Obstetrics & Gynecology | 77 Collier Rd Nw Ste 2010, Atlanta, GA 30309-1754 | 2006-07-10 |
| 1245298082 | Nathan Mordel | Obstetrics & Gynecology | 105 Collier Rd, Ste 1010, Atlanta, GA 30309 | 2006-05-02 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on ATLANTA MEDICAL CENTER PHYSICIAN GROUP, 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.