GRUPO MEDICO DE GEORGIA, LLC (NPI# 1639574890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639574890 |
| Entity Type | Organization |
| Organization Name | GRUPO MEDICO DE GEORGIA, LLC |
| Practice Address |
5955 Jimmy Carter Blvd Suite 100 Norcross GA 30071-4641 |
| Mailing Address |
1400 Buford Hwy Building R-1 Buford GA 30518-8721 |
| Practice Telephone | 7705593555 |
| Mailing Telephone | 7708319202 |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | EDDY LAJARA (GENERAL MANAGER) |
| Authorized Official Telephone | 7708319202 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | CHIR008572 | GA | Chiropractic Providers |
| N | 207Q00000X | Family Medicine | 38981 | GA | Allopathic & Osteopathic Physicians |
| Y | 363L00000X | Nurse Practitioner | RN105078 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5955 JIMMY CARTER BLVD SUITE 100 |
| City | NORCROSS |
| State | GA |
| Zip Code | 30071-4641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477607737 | Steven Ngoc Ha | Family Medicine | 5955 Jimmy Carter Blvd, Suite 40, Norcross, GA 30071-4641 | 2007-01-23 |
| 1093937484 | Judith Grace Lutumba | Registered Nurse | 5955 Jimmy Carter Blvd, Norcross, GA 30071-4641 | 2007-05-03 |
| 1629192026 | Kim Thi Nguyen | Family Medicine | 5955 Jimmy Carter Blvd, Suite 40, Norcross, GA 30071-4641 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477199867 | 1st Senior Cares, LLC | Home Health | 7116 Peachtree Industrial Blvd. Bldg. 4, Ste. B, Peachtree Corners, GA 30071 | 2019-11-21 |
| 1124660048 | Phil Scafidi | Massage Therapist | 50 Skin Alley, Norcross, GA 30071 | 2019-10-11 |
| 1063071454 | Kenanesha Owens | Counselor | 3040 Holcolmb Bridge Rd Suite J2, Norcross, GA 30071 | 2019-06-10 |
| 1407318389 | 1st Senior Homecare, LLC | Home Health | 7116 Peachtree Industrial Blvd., Bldg 4 Suite A, Peachtree Corners, GA 30071 | 2019-04-01 |
| 1982163689 | Jk Acupuncture LLC | Acupuncturist | 5390 Peachtree Industrial Bl #101, Norcross, GA 30071 | 2019-03-13 |
| 1063990778 | First Senior Center | Clinic/Center | 7116 Peachtree Industrial Blvd, Bldg 4, Peachtree Corners, GA 30071 | 2018-08-03 |
| 1952896904 | Sonal P Patel | Physical Therapy Assistant | 4709 Peachtree Ind Blvd, Suite 106, Norcross, GA 30071 | 2018-06-22 |
| 1700392354 | Medlink Ems Inc | Ambulance | 6825 Jimmy Carter Blvd Ste 1303, Norcross, GA 30071 | 2017-12-19 |
| 1205377975 | David Kalisz II | Specialist/Technologist, Other | 1880 Beaver Ridge Circle Suite D, Norcross, GA 30071 | 2017-03-15 |
| 1356792519 | Tiffany Pope | Counselor | 6045 Atlantic Blvd Ste 108, Norcross, GA 30071 | 2016-06-28 |
| Find all providers in zip 30071 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089072 | Diana Maresi Bulimu | Nurse Practitioner | 6050 Peachtree Pkwy # 240-178, Norcross, GA 30092-3336 | 2020-10-08 |
| 1053926923 | Elisa Acevedo | Nurse Practitioner | 5836 Buford Hwy Ste C, Norcross, GA 30071-2581 | 2020-09-08 |
| 1316200579 | Gwinnett Medical Specialists LLC | Nurse Practitioner | 414 Glenleaf Dr, Norcross, GA 30092-6104 | 2012-06-21 |
| 1982239497 | Ying Fu | Nurse Practitioner | 777 W Peachtree St, Norcross, GA 30071-1868 | 2020-03-04 |
| 1215584198 | Julie B Sewell | Nurse Practitioner | 40 Technology Pkwy S Ste 300, Norcross, GA 30092-2924 | 2019-08-24 |
| 1093271124 | Jennifer Nicole Woodall | Nurse Practitioner | 3720 Davinci Ct Ste 400, Norcross, GA 30092-7625 | 2019-02-13 |
| 1093291544 | Linda Johnson | Nurse Practitioner | 6063 Peachtree Pkwy, Norcross, GA 30092-3303 | 2018-07-18 |
| 1134672033 | Carol C Wong | Nurse Practitioner | 4775 Jimmy Carter Blvd, Suite 201, Norcross, GA 30093-3760 | 2016-07-27 |
| 1477970549 | Kami Bonner Pugh | Nurse Practitioner | 3720 Davinci Ct, Suite 400, Norcross, GA 30092-7627 | 2014-03-26 |
| 1548313539 | Barbara Nicole Davis | Nurse Practitioner | 3720 Davinci Ct, Norcross, GA 30092-7627 | 2007-01-21 |
| Find all providers in NORCROSS | ||||
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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.