ATLANTA VA MEDICAL CENTER (NPI# 1306874219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306874219 |
| Entity Type | Organization |
| Organization Name | ATLANTA VA MEDICAL CENTER |
| Practice Address |
1670 Clairmont Rd Decatur GA 30033-4004 |
| Mailing Address |
630 Creekview Blvd Covington GA 30016-3085 |
| Practice Telephone | 4043216111 |
| Practice Fax Number | 4043294632 |
| Mailing Telephone | 7703857377 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MELODYE MARGUERITE JACOBS (CHARGE NURSE) |
| Authorized Official Telephone | 4043216111 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP2201X |
Registered Nurse Specialization: Ambulatory Care |
R109830 | GA | Nursing Service Providers |
| 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 |
| 1265477863 | Atlanta Va Medical Center | Nursing Facility/Intermediate Care Facility | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-06-18 |
| 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 | 163WP2201X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Ambulatory Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245869585 | Erica Nagra | Registered Nurse | 319 W Delaware St, Decatur, MI 49045-1106 | 2020-04-08 |
| 1104994151 | Lauren Ann Woods | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335182 | Rhonda Gabel | Registered Nurse | 14 Legacy Way Ste A, Adairsville, GA 30103-2455 | 2020-08-04 |
| 1003281726 | Kendra Shearer | Registered Nurse | 1241 Channel Park Sw, Marietta, GA 30064-3825 | 2015-12-07 |
| 1053713537 | Renee Arnette Charlton Brown | Registered Nurse | 89 Arcadia Dr, Midway, GA 31320-3070 | 2014-09-16 |
| 1407257835 | Phillip Volkert | Registered Nurse | 1233 Brooklet South Dr, Brooklet, GA 30415-6469 | 2014-09-04 |
| 1215337738 | Sunny Park | Registered Nurse | 13 Splitleaf Ct, Savannah, GA 31419-9656 | 2014-09-03 |
| 1104174531 | Mamboh Ngum Yufenyuy | Registered Nurse | 1657 Southgate Mill Dr Nw, Duluth, GA 30096 | 2012-08-15 |
| 1356584379 | Thea Delora Sullivan | Registered Nurse | 3628 River Heights Xing Se, Marietta, GA 30067-4870 | 2009-04-07 |
| 1922202142 | George Steve Hardman | Registered Nurse | 1640 Powers Ferry Rd Bldg 23, Marietta, GA 30067-1455 | 2007-06-12 |
| 1780751297 | Mobile Healthcare | Registered Nurse | 4749 Limestone Ln Nw, Acworth, GA 30102-6484 | 2006-11-29 |
| 1215969522 | Mary Emily Walker I | Registered Nurse | 421 Shyrewood Dr, Lawrenceville, GA 30043-6452 | 2006-07-07 |
| 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.