IMMUNE RECOVERY FOUNDATION LLC (NPI# 1831128578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831128578 |
| Entity Type | Organization |
| Organization Name | IMMUNE RECOVERY FOUNDATION LLC |
| Practice Address |
4646 N Shallowford Rd Suite 200 Atlanta GA 30338-6304 |
| Practice Telephone | 7704556100 |
| Practice Fax Number | 7274551999 |
| Mailing Telephone | 7704556100 |
| Mailing Fax Number | 7274551999 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | S. EDWARD BRADFORD (OWNER) |
| Authorized Official Telephone | 7704556100 |
| Authorized Official Credential | P.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302F00000X | Exclusive Provider Organization | Managed Care Organizations |
| Street Address |
4646 N SHALLOWFORD RD SUITE 200 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30338-6304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114553278 | Mallory Howe | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2020-03-19 |
| 1548896780 | Jenna Davis | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2020-03-19 |
| 1881220010 | Taylor Lee Howell | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2020-03-19 |
| 1558997791 | Megan Marie Borreson | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2020-03-19 |
| 1942846464 | Katelyn E Atwell | Health Educator | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2019-11-19 |
| 1992347587 | Regenerative Medical Center, PC | Family Medicine | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2019-10-15 |
| 1255973046 | Amy Tarquini | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2019-10-13 |
| 1407321334 | Adelena Marie Izold | Naturopath | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2018-10-08 |
| 1437688355 | Loren Kennedy Psalidas | Dietitian, Registered | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2017-06-05 |
| 1295181261 | Progressive Healthcare & Diagnostics, LLC | General Practice | 4646 N Shallowford Rd, Atlanta, GA 30338-6308 | 2016-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629606264 | Jasmine Donesha Shackelford | Student in an Organized Health Care Education/Training Program | Emory Family Medicine, 4500 North Shallowford Road, Atlanta, GA 30338 | 2020-03-30 |
| 1558907774 | Brianna Harding | Pharmacist | 4608 Devonshire Road, Dunwoody, GA 30338 | 2019-11-22 |
| 1194382135 | Kadan Corporation | In Home Supportive Care | 1848 Independence Square, Suite A, Dunwoody, GA 30338 | 2019-05-24 |
| 1144789553 | Carla Fabiola Nunez | Dentist | 5200 Roberts Dr, Atlanta, GA 30338 | 2019-03-15 |
| 1861978793 | Uhs of Peachford Lp | Pharmacy | 2150 Peachford Rd Ste D, Atlanta, GA 30338 | 2018-07-13 |
| 1275047474 | Mary Rose Ziemba | Physical Therapist | 4516 Chamblee Dunwoody Rd # 22, Dunwoody, GA 30338 | 2017-11-27 |
| 1992223531 | Joel Moorhead | Physical Medicine & Rehabilitation | 1521 Eidson Hall Drive, Dunwoody, GA 30338 | 2017-09-05 |
| 1336667997 | Absolute Holistic Medicine | Clinic/Center | 1868 Independence Sq, Suite A, Atlanta, GA 30338 | 2017-09-05 |
| 1164947115 | Modern Dermatology Atlanta | Dermatology | 5696 Whitehall Walk, Dunwoody, GA 30338 | 2017-08-11 |
| 1366972150 | A Caring Approach To Home Health Services Inc. | In Home Supportive Care | 200 Ashford Center North, Suite 370, Atlanta, GA 30338 | 2017-06-14 |
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| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
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|---|---|---|---|---|
| 1992105258 | My Matrix, Incorporated | Exclusive Provider Organization | 2640 Martin Luther King Jr Dr Sw, Atlanta, GA 30311-6101 | 2014-08-23 |
| 1932536000 | Nrs2000 | Exclusive Provider Organization | 1813 Wee Kirk Rd Se, Atlanta, GA 30316-4435 | 2013-10-03 |
| 1780852921 | Children's Clinic of Atlanta | Exclusive Provider Organization | 2967 A Grandview Ave Ne, Atlanta, GA 30305 | 2008-02-11 |
| 1639549504 | Elite Spectrum Care | Exclusive Provider Organization | 3535 Peachtree Rd Ne, Ste 520-230, Atlanta, GA 30326-3287 | 2015-10-04 |
| 1104294461 | Atlanta Center for Integrative Med | Exclusive Provider Organization | 2751 Buford Hwy Ne, Suite 700, Atlanta, GA 30324-3207 | 2015-09-03 |
| 1649678921 | Smdentalpc | Exclusive Provider Organization | 440 Flat Shoals Ave Se, Atlanta, GA 30316-1915 | 2014-12-18 |
| 1194135459 | Saundra Ann Maass-robinson M D | Exclusive Provider Organization | 1440 Dutch Valley Pl Ne, Suite 985, Atlanta, GA 30324-5366 | 2014-05-07 |
| 1336336338 | Mhm Services, Inc | Exclusive Provider Organization | 34 Peachtree St Nw, Suite 770, Atlanta, GA 30303-2316 | 2007-10-03 |
| 1679777932 | Dream Medical & Rehab, LLC | Exclusive Provider Organization | 2024 Powers Ferry Rd Se, Suite #110, Atlanta, GA 30339-5011 | 2007-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841739984 | Under The Shadows Private Home Care | Exclusive Provider Organization | 208 Curtis Street, Sylvania, GA 30467 | 2017-02-22 |
| 1851830806 | Martinez Orthodontics, PC | Exclusive Provider Organization | 4469 Columbia Rd Ste B, Martinez, GA 30907-4573 | 2017-02-22 |
| 1467900191 | The 831 Company | Exclusive Provider Organization | 788 Hightower Rd, Macon, GA 31206-2240 | 2016-09-11 |
| 1992151567 | Cindys Childrens Charitable & Elderly Care Foundation Inc. | Exclusive Provider Organization | 1249 Kasandra Dr Se, Marietta, GA 30067-7713 | 2016-05-12 |
| 1275925711 | Briah Fashions LLC | Exclusive Provider Organization | 1215 Lionsgate Dr, Conyers, GA 30094-6106 | 2015-02-20 |
| 1356760318 | Specialized Therapy Solutions, LLC | Exclusive Provider Organization | 1494 Hampton View Ct, Marietta, GA 30008-4094 | 2014-04-07 |
| 1558787085 | Qura Woodbury | Exclusive Provider Organization | 464 Vinings Vintage Cir, Mableton, GA 30126-7207 | 2014-03-07 |
| 1285059006 | Brandy Schultz Cares | Exclusive Provider Organization | 1960 Morning Ln Nw, Acworth, GA 30102-7912 | 2014-03-03 |
| 1740604883 | Judin Lynch | Exclusive Provider Organization | 919 Koala Ct, Lawrenceville, GA 30043-7699 | 2014-02-10 |
| 1992127518 | The Bliss Center, Paracletos Institute International | Exclusive Provider Organization | 109 N 85 Pkwy, Suite B, Fayetteville, GA 30214-4003 | 2014-01-16 |
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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.