TMC CHILDREN'S HEALTHCARE OF WEST GEORGIA (NPI# 1518972348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518972348 |
| Entity Type | Organization |
| Organization Name | TMC CHILDREN'S HEALTHCARE OF WEST GEORGIA |
| Other Organization Name | CHILDREN'S HEALTHCARE OF WEST GEORGIA |
| Practice Address |
148 Clinic Ave Carrollton GA 30117-4414 |
| Practice Telephone | 7708388640 |
| Practice Fax Number | 7708388650 |
| Mailing Telephone | 7708388640 |
| Mailing Fax Number | 7708388650 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-06-30 |
| Authorized Official Name | DALE DREILING (SENIOR VP) |
| Authorized Official Telephone | 7708388038 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICAID PAYEE | 300035885C | 01 |
| GA | MEDICAID PAYEE | 300035885A | 01 |
| GA | MEDICAID PAYEE | 300035885B | 01 |
| Other Name | Type Code |
|---|---|
| Children's Healthcare of West Georgia | Other Name - Individual/Organization |
| Street Address |
148 CLINIC AVE |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-4414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659362127 | Suzanne Cahill Manley | Pediatrics | 148 Clinic Ave, Carrollton, GA 30117 | 2005-11-02 |
| 1730557869 | Lyndi Nicole Bowling | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117 | 2015-09-06 |
| 1942683818 | Caroline G Colden | Pediatrics | 148 Clinic Ave, Carrollton, GA 30117 | 2015-07-09 |
| 1346631322 | Elisabeth Mcpherson | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2015-02-11 |
| 1972821148 | Holley Elizabeth Beam | Pediatrics | 148 Clinic Ave, Carrollton, GA 30117 | 2010-05-12 |
| 1255521647 | Keatrina T Springer | Nurse Practitioner | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2007-07-31 |
| 1083651996 | Steven Allen Eubanks Jr. | Pediatrics | 148 Clinic Ave, Carrollton, GA 30117 | 2006-05-31 |
| 1356322424 | Tammy Ann Stewart | Physician Assistant | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2005-11-07 |
| 1427049717 | Nestor Antonio Baldizon | Physician Assistant | 148 Clinic Ave, Carrollton, GA 30117-4414 | 2005-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699215541 | Mary M Feldman Md LLC | Clinic/Center | 100 Professional Pl, Ste 110, Carrollton, GA 30117-3874 | 2017-02-26 |
| 1275698532 | Premier Diabetes Endocrinology, Pa | Clinic/Center | 4100 Fairway Dr Ste 620, Carrollton, TX 75010-6539 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376865 | Deyoe Wellness | Clinic/Center | 47 Commerce Dr Ste 1b, Blairsville, GA 30512-8929 | 2020-08-11 |
| 1992331581 | World Spine and Orthopedics LLC | Clinic/Center | 4296 Memorial Dr Ste C, Decatur, GA 30032-1227 | 2020-03-16 |
| 1619517968 | Carroll Total Healthcare,pc | Clinic/Center | 410 Peachtree Pkwy Ste 4226, Cumming, GA 30041-7439 | 2020-01-14 |
| 1528601200 | Blued Consultant Solutions, LLC | Clinic/Center | 256 Rainbow Ln, Mcdonough, GA 30252-4839 | 2019-10-24 |
| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on TMC CHILDREN'S HEALTHCARE OF WEST GEORGIA.
| 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.