ATLANTA VA MEDICAL CENTER (NPI# 1265477863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265477863 |
| Entity Type | Organization |
| Organization Name | ATLANTA VA MEDICAL CENTER |
| Practice Address |
1670 Clairmont Rd Decatur GA 30033-4004 |
| Mailing Address |
6 Fairfield Dr Ellenwood GA 30294-2810 |
| Practice Telephone | 4043216111 |
| Mailing Telephone | 6788335759 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2008-11-04 |
| Authorized Official Name | MS. YLBA M HOOKER (REGISTERED NURSE) |
| Authorized Official Telephone | 4043216111 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 018134 | PR | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811391691 | Atlanta Va Medical Center | Nursing Facility/Intermediate Care Facility | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2014-10-22 |
| 1093990731 | Atlanta Va Medical Center | General Acute Care Hospital | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2007-12-31 |
| 1073699286 | Atlanta Va Medical Center | Clinic/Center | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-10-31 |
| 1255362729 | Atlanta Va Medical Center | Clinic/Center | 1670 Clairmont Rd, Atlanta Va, Decatur, GA 30033-4004 | 2006-07-05 |
| 1306874219 | Atlanta Va Medical Center | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-06-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ATLANTA VA MEDICAL CENTER | 1670 Clairmont Road, Decatur, GA 30033-4004 |
| Street Address |
1670 CLAIRMONT RD |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342042 | Ketayoun Davari | Pharmacist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2005-08-03 |
| 1730780073 | Mojisola Mary Bakare | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-11-03 |
| 1346849189 | Jessica Astrid George | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-10-22 |
| 1841807591 | Mallorie Gayle Carroll | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-28 |
| 1164036570 | Rachel Heatherly | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-02 |
| 1679186670 | Martale Jerrell Davis | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-28 |
| 1619580206 | Rosetta Yvette Delancy | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-25 |
| 1760095186 | Alaisha Delane Wellons | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-25 |
| 1568074797 | Hannah F Martyn | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-19 |
| 1285245308 | Meera Gupta | Pharmacist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568493930 | Sunny Hills Inc | Nursing Facility/Intermediate Care Facility | 201 E Thompson St, Decatur, TX 76234-2736 | 2006-07-05 |
| 1841229788 | Strategic Care of Decatur, LLC | Nursing Facility/Intermediate Care Facility | 201 E Thompson, Decatur, TX 76234 | 2006-07-02 |
| 1063459329 | Petersen Health & Wellness, LLC | Nursing Facility/Intermediate Care Facility | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2006-06-02 |
| 1811391691 | Atlanta Va Medical Center | Nursing Facility/Intermediate Care Facility | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2014-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861937187 | Organnizer | Nursing Facility/Intermediate Care Facility | 2320 Highway 20 Se, Conyers, GA 30013-2426 | 2016-12-22 |
| 1508228370 | Correcthealth Gdc, LLC | Nursing Facility/Intermediate Care Facility | 1 Bostick Cir, Milledgeville, GA 31062-7526 | 2016-03-22 |
| 1760856645 | 363l00000x | Nursing Facility/Intermediate Care Facility | 2171 Peachtree Rd Ne, Apt 306, Atlanta, GA 30309-6300 | 2015-11-16 |
| 1568846798 | Your Elite Companion Sitting and Healthcare Services | Nursing Facility/Intermediate Care Facility | 3235 Satellite Blvd, Bldg 400 Suite 300, Duluth, GA 30096-8687 | 2015-07-17 |
| 1194141549 | Hospital Authority of Valdosta and Lowndes County, Georgia | Nursing Facility/Intermediate Care Facility | 120 W Thigpen Ave, Lakeland, GA 31635-1011 | 2014-03-10 |
| 1255768024 | Department of Juvenile Justice | Nursing Facility/Intermediate Care Facility | 450 Crescent Dr, Gainesville, GA 30501-5079 | 2013-10-10 |
| 1043576812 | Call To Arm | Nursing Facility/Intermediate Care Facility | 4066 Christacy Way, Marietta, GA 30066-2786 | 2012-04-06 |
| 1881824928 | Tedla-kebede Corp | Nursing Facility/Intermediate Care Facility | 3424 Old Suttons Way, Marietta, GA 30062-4187 | 2009-07-23 |
| 1164642484 | Skidaway Health and Living Services, Inc. | Nursing Facility/Intermediate Care Facility | 95 Skidaway Island Park Rd, Savannah, GA 31411-1104 | 2007-04-27 |
| 1780798314 | Va Hospital | Nursing Facility/Intermediate Care Facility | 7264 Madison Circle, Union City, GA 30291 | 2006-08-19 |
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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.