NORTHEAST GEORGIA MEDICAL CENTER, INC. (NPI# 1790721942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790721942 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA MEDICAL CENTER, INC. |
| Other Organization Name | ERS/LIFELINE |
| Practice Address |
675 White Sulphur Rd Suite 285 Gainesville GA 30501-8921 |
| Mailing Address |
743 Spring St Ne Gainesville GA 30501-3715 |
| Practice Telephone | 7702198899 |
| Practice Fax Number | 7702198898 |
| Mailing Telephone | 7702199000 |
| Mailing Fax Number | 7702196694 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | BRIAN D STEINES (CFO) |
| Authorized Official Telephone | 7702193562 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEAST GEORGIA MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00310362B | 05 |
| Other Name | Type Code |
|---|---|
| ERS/LIFELINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042867 | Northeast Georgia Medical Center, Inc. | Pharmacy | 1439 Jesse Jewell Pkwy Ne, Gainesville, GA 30501-3806 | 2020-04-22 |
| 1124183355 | Northeast Georgia Medical Center, Inc. | Pharmacy | 825 Jesse Jewell Pkwy Se, Suite D, Gainesville, GA 30501-3830 | 2006-12-27 |
| 1649208927 | Northeast Georgia Medical Center, Inc. | Skilled Nursing Facility | 2020 Beverly Rd Ne, Gainesville, GA 30501-2037 | 2006-06-28 |
| 1407892706 | Northeast Georgia Medical Center, Inc. | Skilled Nursing Facility | 675 White Sulphur Road, Gainesville, GA 30501-2621 | 2006-06-22 |
| 1720015993 | Northeast Georgia Medical Center, Inc. | Rehabilitation Unit | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-06-26 |
| 1437185261 | Northeast Georgia Medical Center, Inc. | Psychiatric Unit | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-06-23 |
| 1427055821 | Northeast Georgia Medical Center, Inc. | General Acute Care Hospital | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2005-06-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHEAST GEORGIA MEDICAL CENTER, INC. | 743 Spring St Ne, Gainesville, GA 30501-3715 |
| Street Address |
675 WHITE SULPHUR RD SUITE 285 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-8921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730180936 | John Francis Chiulli | Internal Medicine | 675 White Sulphur Rd, Suite 175, Gainesville, GA 30501-8921 | 2005-08-10 |
| 1992210694 | Margaret Anne Dini | Physical Therapist | 675 White Sulphur Rd, Gainesville, GA 30501-8921 | 2017-12-05 |
| 1851826036 | Georgia Urology Pa | Urology | 675 White Sulphur Rd, Suite 180, Gainesville, GA 30501-8921 | 2017-04-26 |
| 1285905653 | Pulmonary Associates of Gainesville, P.C. | Internal Medicine | 675 White Sulphur Rd, Suite 175, Gainesville, GA 30501-8921 | 2012-01-18 |
| 1700185048 | Rocky Mountain Holdings LLC | Ambulance | 675 White Sulphur Rd, Gainesville, GA 30501 | 2011-03-25 |
| 1902037872 | James R. Burns Jr Md PC | Clinic/Center | 675 White Sulphur Rd, Suite 170, Gainesville, GA 30501-8921 | 2009-07-27 |
| 1700040060 | Allyn C Johnson Jr Mdpc | Internal Medicine | 675 White Sulphur Rd, Suite #280, Gainesville, GA 30501-8921 | 2008-07-16 |
| 1790849057 | James Roy Burns Jr. | Family Medicine | 675 White Sulphur Rd, Suite 170, Gainesville, GA 30501 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1427401942 | Georgia Elite Ambulance Service Inc. | Ambulance | 2445 Hilton Dr, Suite 104, Gainesville, GA 30501-6275 | 2016-07-20 |
| 1144667098 | Delta Ambulance LLC | Ambulance | 2341 Centennial Dr Ste B, Gainesville, GA 30504-5762 | 2013-06-03 |
| 1972802601 | Ambulance Service Management, LLC | Ambulance | 2305 Danbury Ln, Suite C, Gainesville, GA 30507-7311 | 2011-03-21 |
| 1760711659 | Memorial Ambulance LLC | Ambulance | 2441 Hilton Dr # 502, Gainesville, GA 30501-6264 | 2009-12-23 |
| 1326213406 | Ozarks Medical Center | Ambulance | Hc 1 Box 31, Gainesville, MO 65655-9601 | 2008-04-29 |
| 1962513671 | Ngmt,inc | Ambulance | 1742 Candler Rd, Gainesville, GA 30507-8427 | 2006-08-31 |
| 1780610287 | County of Alachua Board of County Commissioners | Ambulance | 911 Se 5 St, Gainesville, FL 32601-8011 | 2006-06-25 |
| 1316932239 | County of Cooke | Ambulance | 305 S Chestnut St, Gainesville, TX 76240-4707 | 2005-09-16 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on NORTHEAST GEORGIA MEDICAL CENTER, INC..
| 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.