THE SOUTHEAST PERMANENTE MEDICAL GROUP (NPI# 1245266956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245266956 |
| Entity Type | Organization |
| Organization Name | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Practice Address |
3495 Piedmont Road Ne Nine Piedmont Center Atlanta GA 30305-1773 |
| Mailing Address |
3495 Piedmont Rd Ne Nine Piedmont Center Atlanta GA 30305-1773 |
| Practice Telephone | 4043643821 |
| Mailing Telephone | 4043643821 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2017-07-18 |
| Authorized Official Name | MR. MICHAEL DOHERTY (ASSOCIATE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4043642245 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
3495 PIEDMONT ROAD NE NINE PIEDMONT CENTER |
| City | ATLANTA |
| State | GA |
| Zip Code | 30305-1773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063793180 | Christianah Kolajo | Pharmacist | 3495 Piedmont Road Ne, Pharmacy Administration, Building 10, Atlanta, GA 30305 | 2011-09-02 |
| 1861772204 | Deborah L Baker | Pharmacist | 3495 Piedmont Road Ne, Atlanta, GA 30305-1736 | 2011-08-17 |
| 1548308372 | Gail C Richardson | Internal Medicine | 3495 Piedmont Road Ne, Department of Medicine, Atlanta, GA 30305 | 2007-02-02 |
| 1912069725 | Sara H Mitchell | Pediatrics | 3495 Piedmont Road Ne, Department of After Hours, Atlanta, GA 30305 | 2006-12-15 |
| 1376638122 | Charles P Ellington IIi | Obstetrics & Gynecology | 3495 Piedmont Road Ne, Department of Obstetrics & Gynecology, Atlanta, GA 30305-1736 | 2006-10-04 |
| 1790876217 | Rhoda K Sharp | Internal Medicine | 3495 Piedmont Road Ne, Medical Officies Administration, Atlanta, GA 30305 | 2006-09-28 |
| 1558476937 | Carole S Gardner | Family Medicine | 3495 Piedmont Road Ne, Medical Offices Administration, Atlanta, GA 30305 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659981322 | Gerald E Roettger | Physical Therapist | 2955 Peachtree Road Nw, Suite A1, Atlanta, GA 30305 | 2020-08-06 |
| 1689202681 | Pt Hills Place Terraces LLC | Assisted Living Facility | 229 Peachtree Hills Place, Atlanta, GA 30305 | 2020-03-27 |
| 1043704299 | Alyssa Elrod Utz | Pharmacist | 3495 Piedmont Road, First Floor, Suite 110, Atlanta, GA 30305 | 2018-06-20 |
| 1508373689 | Kathryn Gohde | Counselor | 3525 Piedmont Rd Nw, Bldg 7 Suite 408, Atlanta, GA 30305 | 2018-01-10 |
| 1386195154 | Ryan Gabriel Wilkins | Physical Therapist | 550 Pharr Rd Ne Ste 550, Atlanta, GA 30305 | 2016-10-17 |
| 1821440587 | Monica Martinez Dicristina | Counselor | 3525 Piedmont Road, Building 7, Suite 408, Atlanta, GA 30305 | 2016-07-06 |
| 1164879532 | Brittany Nicole Albritton | Physical Therapist | 3169 Maple Drive Ne, Atlanta, GA 30305 | 2016-05-16 |
| 1588039275 | Alaina Blevins | Physician Assistant | 240 Pharr Rd Ne, Atlanta, GA 30305 | 2015-12-07 |
| 1558750141 | A2h2 | Clinic/Center | 2909 Peachtree Rd; Nw;, Atlanta, GA 30305 | 2015-01-20 |
| 1144619016 | We Up Home Health Services LLC | Clinic/Center | 2909 Peachtree Rd; Nw, Atlanta, GA 30305 | 2015-01-15 |
| Find all providers in zip 30305 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1679137657 | Internal Medicine Consulting Services | Internal Medicine | 3365 Piedmont Rd Ne Ste 1400, Atlanta, GA 30305-1795 | 2019-04-25 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1326527144 | Vergena Montgomery Clark | Internal Medicine | 3142 Esplanade Cir Sw, Atlanta, GA 30311-4221 | 2018-08-13 |
| 1790299071 | Jay Leonard Lichtenfeld | Internal Medicine | 1711 E Clifton Rd Ne, Atlanta, GA 30307-1247 | 2017-11-26 |
| 1558872432 | Qcpi-villagemd, PC | Internal Medicine | 3445 Peachtree Rd Ne Ste 1200, Atlanta, GA 30326-3251 | 2017-10-18 |
| 1033640115 | Christopher Massad | Internal Medicine | 1364 Clifton Rd Ne Ste H-153, Atlanta, GA 30322-1059 | 2017-03-21 |
| 1114377025 | Atlanta Clinical Research Centers LLC | Internal Medicine | 5673 Peachtree Dunwoody Rd Ste 440, Atlanta, GA 30342-1797 | 2016-06-21 |
| Find all providers in ATLANTA | ||||
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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.