NORTHSIDE URGENT CARE HOLDING, LLC (NPI# 1295124147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295124147 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE URGENT CARE HOLDING, LLC |
| Practice Address |
1000 Johnson Fy Rd Ne Atlanta GA 30342-1606 |
| Practice Telephone | 4048518809 |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |
| Authorized Official Name | JORGE J. HERNANDEZ (VP OD ADMIN SERVICES AND CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679962237 | Northside Urgent Care Holding, LLC | General Practice | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2015-01-20 |
| Street Address |
1000 JOHNSON FY RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548296684 | Raghuveer Suryadevara | Internal Medicine | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2006-06-23 |
| 1114524592 | Bonnie Bell | Nurse Anesthetist, Certified Registered | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2020-10-08 |
| 1073129581 | Amanda Walter | Clinical Nurse Specialist | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1611 | 2020-09-21 |
| 1831705557 | Christina Nicole Di Natale | Registered Nurse | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1611 | 2020-09-17 |
| 1497369516 | Melony Ethel Shelton | Nurse Practitioner | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2020-09-04 |
| 1134748320 | Adity Dutta | Registered Nurse | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1611 | 2020-04-08 |
| 1548893050 | Whitney Addison | Registered Nurse | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2020-02-13 |
| 1962032912 | Brandon Brand | Nurse Practitioner | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2020-01-17 |
| 1790321867 | Carla Bray | Registered Nurse | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2019-11-22 |
| 1851934244 | Sarah Brianne Sammons | Nurse Practitioner | 1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606 | 2019-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1912521782 | Eagles Landing Family Practice, LLC | Family Medicine | 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339-3304 | 2020-06-08 |
| 1487297164 | Deavmed L.l.c | Family Medicine | 3915 Cascade Rd Sw Ste T-90, Atlanta, GA 30331-8660 | 2019-10-24 |
| 1598319287 | Vibrant Family Medicine, P.C. | Family Medicine | 6667 Vernon Woods Dr Ste A19, Atlanta, GA 30328-3215 | 2019-07-30 |
| 1649739020 | Accumedic Diagnostic Management LLC | Family Medicine | 373 W Lake Ave Nw, Atlanta, GA 30318-8123 | 2019-03-15 |
| 1679037758 | Harrigan Medical Consulting Services, Inc | Family Medicine | 3280 Howell Mill Rd Nw Ste 207, Atlanta, GA 30327-4100 | 2019-01-23 |
| 1184197337 | Todd Ware Davis | Family Medicine | 942 Fern Ave Se, Atlanta, GA 30315-1813 | 2019-01-09 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1265902092 | Gregory Stephen Wallace | Family Medicine | 1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802 | 2018-12-05 |
| 1124596069 | Longevity Medical Center, PC | Family Medicine | 4646 N Shallowford Rd Ste 300, Atlanta, GA 30338-6308 | 2018-11-08 |
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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.