363L00000X (NPI# 1760856645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760856645 |
| Entity Type | Organization |
| Organization Name | 363L00000X |
| Practice Address |
2171 Peachtree Rd Ne Apt 306 Atlanta GA 30309-6300 |
| Practice Telephone | 6784649424 |
| Mailing Telephone | 6784649424 |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |
| Authorized Official Name | MRS. ANETHA DEBORAH PETERSON (NURSE PRACTITIONER) |
| Authorized Official Telephone | 6784649424 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 363L00000X | GA | Nursing & Custodial Care Facilities |
| Street Address |
2171 PEACHTREE RD NE APT 306 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30309-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382354 | Astoria Dentistry LLC | Dentist | 2233 Peachtree Rd. Nw, Suite 300, Atlanta, GA 30309 | 2019-12-09 |
| 1487133740 | S2 Telehealth Technologies, LLC | Psychiatry & Neurology | 915 W Peachtree St Nw Apt 522, Atlanta, GA 30309 | 2018-08-08 |
| 1841782620 | Janie Mardis | Social Worker | 3 Park Ln Ne, Apt H, Atlanta, GA 30309 | 2018-06-06 |
| 1083102842 | Veronica L Bentley | Specialist/Technologist, Other | 1170 Peachtree Street Suite 1200, Atlanta, GA 30309 | 2018-04-27 |
| 1427566363 | Net Medical Corp | Chiropractor | 1100 Spring St Sw, Ste#700, Atlanta, GA 30309 | 2018-01-12 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1306377817 | Aliyah Lamis Scott | Social Worker | 1745 Peachtree Road Ne, Kaiser Permanente Brookwood Medical Office, Atlanta, GA 30309 | 2017-03-26 |
| 1013450774 | Caroline Hallen | Nurse Practitioner | 105 Collier Rd Nw Suite 3040, Atlanta, GA 30309 | 2016-11-29 |
| 1528501723 | Ant-aging Queen | Nutritionist | 1801 Atlanta Medical Clinic, Suite 250, Atlanta, GA 30309 | 2016-11-21 |
| 1790231439 | Nurse 2 Health Home Care LLC | Home Health | 1075 Peachtree Street Ne, Atlanta, GA 30309 | 2016-09-01 |
| Find all providers in zip 30309 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346661568 | L & P Multicare Service, Inc | Nursing Facility/Intermediate Care Facility | 2596 Donald Lee Hollowell Pkwy Nw, Atlanta, GA 30318-8300 | 2013-12-16 |
| 1194168062 | Fulton County Government | Nursing Facility/Intermediate Care Facility | 186 Sunset Ave Nw, Atlanta, GA 30314-4059 | 2013-04-10 |
| 1578834008 | Emory Healthcare | Nursing Facility/Intermediate Care Facility | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2012-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861937187 | Organnizer | Nursing Facility/Intermediate Care Facility | 2320 Highway 20 Se, Conyers, GA 30013-2426 | 2016-12-22 |
| 1508228370 | Correcthealth Gdc, LLC | Nursing Facility/Intermediate Care Facility | 1 Bostick Cir, Milledgeville, GA 31062-7526 | 2016-03-22 |
| 1568846798 | Your Elite Companion Sitting and Healthcare Services | Nursing Facility/Intermediate Care Facility | 3235 Satellite Blvd, Bldg 400 Suite 300, Duluth, GA 30096-8687 | 2015-07-17 |
| 1194141549 | Hospital Authority of Valdosta and Lowndes County, Georgia | Nursing Facility/Intermediate Care Facility | 120 W Thigpen Ave, Lakeland, GA 31635-1011 | 2014-03-10 |
| 1255768024 | Department of Juvenile Justice | Nursing Facility/Intermediate Care Facility | 450 Crescent Dr, Gainesville, GA 30501-5079 | 2013-10-10 |
| 1043576812 | Call To Arm | Nursing Facility/Intermediate Care Facility | 4066 Christacy Way, Marietta, GA 30066-2786 | 2012-04-06 |
| 1881824928 | Tedla-kebede Corp | Nursing Facility/Intermediate Care Facility | 3424 Old Suttons Way, Marietta, GA 30062-4187 | 2009-07-23 |
| 1164642484 | Skidaway Health and Living Services, Inc. | Nursing Facility/Intermediate Care Facility | 95 Skidaway Island Park Rd, Savannah, GA 31411-1104 | 2007-04-27 |
| 1780798314 | Va Hospital | Nursing Facility/Intermediate Care Facility | 7264 Madison Circle, Union City, GA 30291 | 2006-08-19 |
| 1366461857 | Evans Memorial Hospital, Inc. | Nursing Facility/Intermediate Care Facility | 721 N Downing Musgrove Hwy, Glennville, GA 30427-2208 | 2006-07-18 |
| Find all providers with the same taxonomy | ||||
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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.