NORMAN PARK FAMILY MEDICINE CLINIC (NPI# 1518398049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518398049 |
| Entity Type | Organization |
| Organization Name | NORMAN PARK FAMILY MEDICINE CLINIC |
| Practice Address |
139 East Broad Street Norman Park GA 31771 |
| Mailing Address |
Po Box 110 Norman Park GA 31771-0110 |
| Practice Telephone | 2297693500 |
| Practice Fax Number | 2297693501 |
| Mailing Telephone | 2297693500 |
| Mailing Fax Number | 2297693501 |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | AMANDA L ROBERTS (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 2298919131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003155331A | 05 | |
| GA | MEDICARE PART A | 11-8912 | 01 |
| Street Address |
139 EAST BROAD STREET |
| City | NORMAN PARK |
| State | GA |
| Zip Code | 31771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780092684 | Carolyn Fowler | Nurse Practitioner | 139 East Broad Street, Norman Park, GA 31771 | 2014-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043203508 | Geri A Hester | Speech-Language Pathologist | 372 Jp Perry Rd, Norman Park, GA 31771-4041 | 2005-08-30 |
| 1598228033 | Tammi Love | Contractor | 1787 Earnest Norman Rd, Norman Park, GA 31771-5600 | 2019-04-11 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1992147573 | Doerun Family Medicine Clinic | Clinic/Center | 128 West Broad Ave, Doerun, GA 31744 | 2013-07-23 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1376778001 | Phoebe Sumter Medical Center, Inc | Clinic/Center | 339 S Broad St, Ellaville, GA 31806-3304 | 2009-05-26 |
| 1720227895 | The Baxley and Appling County Hospital Authority | Clinic/Center | 105 E Tollison St, Suite D, Baxley, GA 31513-0149 | 2009-02-13 |
| Find all providers with the same taxonomy | ||||
| City | NORMAN PARK |
| Zip Code | 31771 |
Please comment or provide details below to improve the information on NORMAN PARK FAMILY MEDICINE CLINIC.
| 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.