EAGLES LANDING FAMILY PRACTICE, LLC (NPI# 1912521782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912521782 |
| Entity Type | Organization |
| Organization Name | EAGLES LANDING FAMILY PRACTICE, LLC |
| Practice Address |
3333 Riverwood Pkwy Se Ste 250 Atlanta GA 30339-3304 |
| Practice Telephone | 7709140116 |
| Practice Fax Number | 7709147520 |
| Mailing Telephone | 7709140116 |
| Mailing Fax Number | 7709147520 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | WENDY HICKS (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7709140116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144483744 | Eagles Landing Family Practice, LLC | Family Medicine | 1101 Nortec Dr Se, Conyers, GA 30013-5835 | 2008-07-03 |
| 1710079850 | Eagles Landing Family Practice, LLC | Family Medicine | 649 Jonesboro Road, Mcdonough, GA 30253 | 2006-09-28 |
| 1902907207 | Eagles Landing Family Practice, LLC | Family Medicine | 62 Kelly Rd, Mcdonough, GA 30253-6012 | 2006-09-26 |
| 1013018811 | Eagles Landing Family Practice, LLC | Family Medicine | 2330 Patrick Henry Pkwy, Suite 200, Mcdonough, GA 30253-4220 | 2006-09-26 |
| 1649623380 | Eagles Landing Family Practice, LLC | Family Medicine | 1240 Eagles Landing Pkwy, Suite 110, Stockbridge, GA 30281-5170 | 2016-07-18 |
| 1154774883 | Eagles Landing Family Practice, LLC | Internal Medicine | 145 Eagles Walk, Stockbridge, GA 30281-7340 | 2016-07-18 |
| 1578827655 | Eagles Landing Family Practice, LLC | Radiology | 1100 Hospital Dr, Stockbridge, GA 30281-6381 | 2012-07-03 |
| 1073829073 | Eagles Landing Family Practice, LLC | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2010-08-27 |
| 1770744450 | Eagles Landing Family Practice, LLC | Family Medicine | 65 Old Jackson Rd, Mcdonough, GA 30252-3095 | 2008-06-24 |
| 1205919263 | Eagles Landing Family Practice, LLC | Family Medicine | 1502 Highway 16 E, Jackson, GA 30233-5202 | 2006-10-23 |
| Street Address |
3333 RIVERWOOD PKWY SE STE 250 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30339-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303426 | Cheryl E Williams | Counselor | 1870 The Exchange, Suite 200 - 361, Atlanta, GA 30339 | 2020-07-20 |
| 1245854371 | Synergia Integrated Telebehavioral Health | Clinic/Center | 3941 Old Atlanta Station Drive, Southeast, Atlanta, GA 30339 | 2020-06-04 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1013499821 | Deonna Pennamon | Specialist/Technologist | 5625 Suffex Green Lane, Atlanta, GA 30339 | 2018-08-29 |
| 1205326915 | Matthew Buyert | Counselor | 1827 Powers Ferry Rd Se Ste 22, Atlanta, GA 30339 | 2018-05-17 |
| 1760991632 | Horizons Unlimited Professional Services Inc. | Community/Behavioral Health | 1755 The Exchange Se Ste 190, Atlanta, GA 30339 | 2017-09-23 |
| 1932624418 | Kheder Basheer | Student in an Organized Health Care Education/Training Program | 3224 Post Woods Dr., Apt E, Atlanta, GA 30339 | 2017-08-07 |
| 1417486820 | Ashley Drake | Counselor | 4695 N Church Ln Se Apt 10306, Atlanta, GA 30339 | 2017-06-08 |
| 1992248298 | New Legacy Counseling and Training Center | Point of Service | 3350 Riverwood Parkway, Suite 1925, Atlanta, GA 30339 | 2016-11-18 |
| Find all providers in zip 30339 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1487297164 | Deavmed L.l.c | Family Medicine | 3915 Cascade Rd Sw Ste T-90, Atlanta, GA 30331-8660 | 2019-10-24 |
| 1598319287 | Vibrant Family Medicine, P.C. | Family Medicine | 6667 Vernon Woods Dr Ste A19, Atlanta, GA 30328-3215 | 2019-07-30 |
| 1649739020 | Accumedic Diagnostic Management LLC | Family Medicine | 373 W Lake Ave Nw, Atlanta, GA 30318-8123 | 2019-03-15 |
| 1679037758 | Harrigan Medical Consulting Services, Inc | Family Medicine | 3280 Howell Mill Rd Nw Ste 207, Atlanta, GA 30327-4100 | 2019-01-23 |
| 1184197337 | Todd Ware Davis | Family Medicine | 942 Fern Ave Se, Atlanta, GA 30315-1813 | 2019-01-09 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1265902092 | Gregory Stephen Wallace | Family Medicine | 1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802 | 2018-12-05 |
| 1124596069 | Longevity Medical Center, PC | Family Medicine | 4646 N Shallowford Rd Ste 300, Atlanta, GA 30338-6308 | 2018-11-08 |
| 1376022434 | Neena Bhatia | Family Medicine | 2840 Ne Expy Ne, Atlanta, GA 30345-4214 | 2018-08-09 |
| 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.