DIVINITY INTERNAL MEDICINE & ASSOCIATES INC. (NPI# 1902167935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902167935 |
| Entity Type | Organization |
| Organization Name | DIVINITY INTERNAL MEDICINE & ASSOCIATES INC. |
| Practice Address |
494 Boulevard Se Atlanta GA 30312-3426 |
| Mailing Address |
4426 Hugh Howell Rd Ste B160 Tucker GA 30084-4918 |
| Practice Telephone | 4046071002 |
| Mailing Telephone | 6787240862 |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |
| Authorized Official Name | MR. KYWAIN REID (PRESIDENT) |
| Authorized Official Telephone | 6787240862 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 154999 | GA | Managed Care Organizations |
| Street Address |
494 BOULEVARD SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-3426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407877764 | Progressive Community Healthcare | Clinic/Center | 494 Boulevard Se, Atlanta, GA 30312-3426 | 2006-07-22 |
| 1538453444 | K & L Cardiovascular | Internal Medicine | 494 Boulevard Se, Atlanta, GA 30312-3426 | 2011-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "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. 62 |
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| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1992248298 | New Legacy Counseling and Training Center | Point of Service | 3350 Riverwood Parkway, Suite 1925, Atlanta, GA 30339 | 2016-11-18 |
| 1932575438 | Marion Hargett | Point of Service | 502 Pryor St Sw, Atlanta, GA 30312-2760 | 2015-08-19 |
| 1447688163 | Atlanta Integrated Medical Health Center | Point of Service | 626 Parkway Dr Ne, Atlanta, GA 30308-2614 | 2013-10-15 |
| 1699016279 | Pamela Rene Luxurious Hair Salon | Point of Service | 1151 Hammond Dr Ne, Suite 200, Atlanta, GA 30346-1524 | 2013-03-07 |
| 1275684797 | Fountain Oaks Dental P.C. | Point of Service | 3763 Roswell Rd Ne, Atlanta, GA 30342-4414 | 2007-01-12 |
| 1265593446 | Lacy and Company | Point of Service | 1420 Foxhall Ln Se Apt 8, Atlanta, GA 30316-3474 | 2006-12-12 |
| 1659901452 | Ms. Guity, Lcsw. LLC | Point of Service | 2636 Martin Luther King Jr Dr Sw, Atlanta, GA 30311-1634 | 2020-01-21 |
| 1073944997 | Cosmetic Family & Implant Dentistry of Atlanta | Point of Service | 3350 Riverwood Pkwy Se, Suite 2120, Atlanta, GA 30339-6401 | 2013-12-03 |
| 1144660283 | Anita S. Gordon | Point of Service | 2814 Buford Hwy Ne, Atlanta, GA 30329-2103 | 2013-07-03 |
| Find all providers in ATLANTA | ||||
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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.