NORTHEAST GEORGIA SPECIALTY GROUP LLC


Address: 601 S Enota Dr Ne, Suite Q, Gainesville, GA 30501-2400
Phone: 7705338400

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).

Provider Overview

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.

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Neurology Physician Group and Advantage Sports Medicine Doing Business As Name - Organization

Office Location

Street Address 601 S ENOTA DR NE
SUITE Q
City GAINESVILLE
State GA
Zip Code 30501-2400

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

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City GAINESVILLE
Zip Code 30501

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Dataset Information

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.

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