NORTHEAST GEORGIA SPECIALTY GROUP LLC (NPI# 1447443387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447443387 |
Entity Type | Organization |
Organization Name | NORTHEAST GEORGIA SPECIALTY GROUP LLC |
Other Organization Name | NEUROLOGY PHYSICIAN GROUP AND ADVANTAGE SPORTS MEDICINE |
Practice Address |
601 S Enota Dr Ne Suite Q Gainesville GA 30501-2400 |
Practice Telephone | 7705338400 |
Practice Fax Number | 7705338409 |
Mailing Telephone | 7705338400 |
Mailing Fax Number | 7705338409 |
Enumeration Date | 2007-08-23 |
Last Update Date | 2008-04-28 |
Authorized Official Name | MARK KLEIN (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 7705338406 |
Is Organization Subpart | Y |
Parent Organization Name | NORTHEAST GEORGIA PRIMARY CARE, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
Y | 174400000X | Specialist | Other Service Providers | ||
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Neurology Physician Group and Advantage Sports Medicine | Doing Business As Name - Organization |
Street Address |
601 S ENOTA DR NE SUITE Q |
City | GAINESVILLE |
State | GA |
Zip Code | 30501-2400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
Find all providers in zip 30501 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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1871021832 | Hifu Solution LLC | Specialist | 3426 Nw 43rd St Ste B, Gainesville, FL 32606-8156 | 2017-06-02 |
1457888380 | Birth Plus, LLC | Specialist | 4030 Lyman Way, Gainesville, GA 30507-8697 | 2017-05-23 |
1558804609 | Lisa Kelli Glenn | Specialist | 6450 Sw Archer Rd, 210, Gainesville, FL 32608-6133 | 2016-11-22 |
1730534371 | Crest Physical Therapy, Inc. | Specialist | 3754 Sw 56th Rd, Gainesville, FL 32608-5132 | 2016-05-02 |
1588053532 | Jacquelyn Rosado | Specialist | 2035 Sw 75th St Ste B, Suite B, Gainesville, FL 32607-3425 | 2015-01-14 |
1013358555 | Violet Kyong | Specialist | 4910 Sw 64th Rd, Gainesville, FL 32608-8803 | 2013-07-12 |
1740628957 | Caitlyn Kloss | Specialist | 900 Nw 8th Avenue, Gainesville, FL 32601 | 2013-06-10 |
1487917332 | Joseph Desiderious Kovacs Jr. | Specialist | 4430 Nw 18th Pl, Gainesville, FL 32605-3424 | 2012-06-15 |
1093074635 | Julia Jan Phillips | Specialist | 5207 Sw 91st Ter, Gainesville, FL 32608-7125 | 2012-05-15 |
1457635179 | Tina Gorske | Specialist | 1715 Nw 22nd Dr, Gainesville, FL 32605-3953 | 2011-09-29 |
Find all providers in GAINESVILLE |
City | GAINESVILLE |
Zip Code | 30501 |
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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.