EAGLES LANDING MEDICAL CENTER (NPI# 1598120271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598120271 |
| Entity Type | Organization |
| Organization Name | EAGLES LANDING MEDICAL CENTER |
| Other Organization Name | MULTI SPECIALIST PRACTICE |
| Practice Address |
1215 Eagles Landing Pkwy Ste 205 Stockbridge GA 30281-7280 |
| Practice Telephone | 7703899116 |
| Mailing Telephone | 7703899116 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2016-01-05 |
| Authorized Official Name | SHARON SELENA DUNCAN (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 6786567203 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 52394 | GA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NPI NUMBER | 1144255399 | 01 |
| Other Name | Type Code |
|---|---|
| MULTI SPECIALIST PRACTICE | Doing Business As Name - Organization |
| Street Address |
1215 EAGLES LANDING PKWY STE 205 |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-7280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706217 | Veronica Vante | Family Medicine | 200 Business Center Dr Ste 204, Stockbridge, GA 30281-9025 | 2020-09-29 |
| 1730714106 | Berkshire Whole Health PC | Family Medicine | 8 Pine St, Stockbridge, MA 01262-9706 | 2020-03-06 |
| 1982998977 | Richard Lawrence Antonio | Family Medicine | 3515 Highway 138 Se, Stockbridge, GA 30281-7821 | 2011-06-07 |
| 1174834980 | Eagle's Landing Family Practice | Family Medicine | 1108 Hospital Dr, Stockbridge, GA 30281-6381 | 2010-06-25 |
| 1215255500 | Brenda Uche Iyamu | Family Medicine | 1050 Eagles Landing Parkway, Suite 200, Stockbridge, GA 30281 | 2010-05-11 |
| 1083879027 | Clifford Lee Kauffman | Family Medicine | 123 Eva Ln, Stockbridge, GA 30281-6042 | 2008-07-18 |
| 1447376058 | Joseph G Saulsbury II | Family Medicine | 3576 Highway 138 Se, Stockbridge, GA 30281 | 2007-03-22 |
| 1750413779 | Versie Lee Slay | Family Medicine | 145 Eagles Walk Ste A, Stockbridge, GA 30281-7340 | 2007-03-12 |
| 1538178728 | Sonia Andrea Brown | Family Medicine | 3588 Hwy 138, Ste 166, Stockbridge, GA 30281-7148 | 2006-08-05 |
| 1023022852 | The Doctor's Office, LLC | Family Medicine | 921 Eagles Landing Pkwy, Stockbridge, GA 30281-5011 | 2006-07-28 |
| Find all providers in STOCKBRIDGE | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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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.