PARK RIDGE HEALTHCARE AND PHYSICAL MEDICINE LLC (NPI# 1366971277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366971277 |
| Entity Type | Organization |
| Organization Name | PARK RIDGE HEALTHCARE AND PHYSICAL MEDICINE LLC |
| Practice Address |
2896 Chamblee Tucker Road Suite 4 Atlanta GA 30341 |
| Mailing Address |
2896 Chamblee Tucker Rd Ste 2 Atlanta GA 30341-4009 |
| Practice Telephone | 7704570584 |
| Practice Fax Number | 7704570773 |
| Mailing Telephone | 7704570584 |
| Mailing Fax Number | 7704570773 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | DR. PATRICK JOSEPH SALLARULO (OWNER) |
| Authorized Official Telephone | 7704570584 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 111N00000X | Chiropractor | CHIR002472 | GA | Chiropractic Providers |
| Street Address |
2896 CHAMBLEE TUCKER ROAD SUITE 4 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992207344 | Rabun Marie Robertson | Occupational Therapist | 2320 Perimeter Park Drive, Atlanta, GA 30341 | 2018-03-01 |
| 1568986313 | Charles Edge IIi | Nurse Practitioner | 4770 Buford Highway, Atlanta, GA 30341 | 2017-08-02 |
| 1437502937 | Chara Mcgill | Counselor | 13207 Jefferson Circle N, Chamblee, GA 30341 | 2016-07-20 |
| 1982063913 | Stepping Stone of Atlanta | Community/Behavioral Health | 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2016-02-18 |
| 1013317577 | Marne Day | Counselor | 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2014-09-02 |
| 1013343680 | Keelan Walker | Speech-Language Pathologist | 4961 Buford Highway Suite 201, Suite 201, Chamblee, GA 30341 | 2013-09-16 |
| 1578901955 | Promonitor LLC | Electrodiagnostic Medicine | 3300 Northwest Expy Bldg 7, Atlanta, GA 30341 | 2013-06-07 |
| 1639415359 | Lawanda B Cooke | Health Educator | 5280 Peachtree Ind Blvd, Chamblee, GA 30341 | 2012-12-28 |
| 1457602773 | Arthur Macrae Wendel | Family Medicine | 4770 Buford Hwy Ms F60, Atlanta, GA 30341 | 2012-09-26 |
| 1760732325 | Jennifer C Guerin | Speech-Language Pathologist | 2900 Chamblee Tucker Rd Bldg 11, Suite 200-c, Atlanta, GA 30341 | 2012-09-11 |
| Find all providers in zip 30341 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129441 | Ian Michael Koll | Chiropractor | 6100 Lake Forrest Dr Ste 320, Atlanta, GA 30328-3835 | 2020-09-21 |
| 1831713684 | Asia Barclay | Chiropractor | 6855 Foxfire Pl, Atlanta, GA 30349-1384 | 2020-06-07 |
| 1639793664 | 100 Percent Chiropractic Sberger LLC | Chiropractor | 2250 Marietta Blvd, Suite 303, Atlanta, GA 30318 | 2020-06-05 |
| 1427672120 | Brittany Guifarro | Chiropractor | 552 Ponce De Leon Ave Ne Ste 552, Atlanta, GA 30308-1806 | 2020-05-29 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1750900858 | Jill Driver | Chiropractor | 1390 Lanier Blvd Ne, 1409-a, Atlanta, GA 30306 | 2020-04-09 |
| 1972131043 | Rebecca Katherine Young | Chiropractor | 4895 Atlanta Rd Se Ste 124b, Atlanta, GA 30339-1518 | 2020-04-01 |
| 1083249734 | Tia Hill | Chiropractor | 457 Flat Shoals Ave Se Ste 4, Atlanta, GA 30316-1962 | 2020-03-03 |
| 1518599513 | Shawn Robinson | Chiropractor | 659 Auburn Ave Ne Ste G04, Atlanta, GA 30312-1953 | 2020-02-07 |
| 1174155394 | Keishla Yaritza Roman Ramos | Chiropractor | 3151 Stillhouse Creek Dr Se, Atlanta, GA 30339-3537 | 2020-02-05 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on PARK RIDGE HEALTHCARE AND PHYSICAL MEDICINE 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.