Modesta Tako (NPI# 1063410827, PAC ID# 2466415849) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1063410827 |
| PAC ID by PECOS | 2466415849 |
| Professional Enrollment ID | I20150925001612 |
| Full Name | Modesta Tako |
| Organization Legal Name | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Address |
1175 Cascade Pkwy Sw Atlanta GA 30311-3090 |
| Phone Number | 4045054012 |
| Gender | F |
| Credential | MD |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6204829013 |
| Number of Group Practice Members | 600 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 4045054012 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Organization Legal Name | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Physicians | 720 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sapna Ashok Patel | Otolaryngology | The Southeast Permanente Medical Group | 2470 Mount Zion Pkwy, Bldg 200, Jonesboro, GA 30236-2500 |
| Gloria Eberechukwu Okoye | Nurse Practitioner | The Southeast Permanente Medical Group | 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 |
| Joan Mary Gopin | Hospitalist | The Southeast Permanente Medical Group | 2525 Cumberland Pkwy Se, Atlanta, GA 30339-3915 |
| Sandra Nicole Jackson-dent | Family Medicine | The Southeast Permanente Medical Group | 2240 Fountain Dr, Snellville, GA 30078-2919 |
| Emily K Deschler | Ophthalmology | The Southeast Permanente Medical Group | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 |
| Vicki L Yates | Certified Nurse Midwife (cnm) | The Southeast Permanente Medical Group | 6875 Douglas Blvd, Suite A, Douglasville, GA 30135-7155 |
| Lisa Michaels | Podiatry | The Southeast Permanente Medical Group | 200 Crescent Ctr Pkwy, Tucker, GA 30084-7047 |
| Seema Panduranga Kini | Dermatology | The Southeast Permanente Medical Group | 1435 Broadmoor Blvd, Buford, GA 30518-5408 |
| Samir Patel | Internal Medicine | The Southeast Permanente Medical Group | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 |
| Carolyn Commodore-turner | Clinical Social Worker | The Southeast Permanente Medical Group | 1745 Peachtree St Ne, Suite U, Atlanta, GA 30309-2479 |
| Street Address |
1175 CASCADE PKWY SW |
| City | ATLANTA |
| State | GA |
| Zip | 30311-3090 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia Kelly | Family Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| James W Ragins | Internal Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Joy Ekpo Uya | Internal Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Charles D Fowler Jr. | Internal Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Kristy Z Levarity Conley | Family Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Sheila Kennedy | Family Practice | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| George L Perryman Iii | Family Practice | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Marilavinia Jones | Internal Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Lynette L Allen Pye | Certified Nurse Midwife | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tracey Greene-johnson | Obstetrics/gynecology | 2600 Martin L K Jr Dr Sw, Atlanta, GA 30311 | |
| Charlene Turner | Clinical Social Worker | Health Education, Assessment and Leadership, Inc | 2600 Martin L K Jr Dr Sw, Atlanta, GA 30311 |
| Idrissa N Ismail-joseph | Internal Medicine | Health Education, Assessment and Leadership, Inc | 2600 Martin L K Jr Dr Sw, Atlanta, GA 30311 |
| Hannah Akosua Quarshie | Nurse Practitioner | 2457 Martin Luther King Jr Dr Sw A, Atlanta, GA 30311-1712 | |
| Minal Patel | Nurse Practitioner | Minute Clinic LLC | 2429 Martin Luther King Jr Swdr, Atlanta, GA 30311-1713 |
| Shauntae K Walker | Nurse Practitioner | Minute Clinic LLC | 2429 Martin Luther King Jr Swdr, Atlanta, GA 30311-1713 |
| Sarah A Reid Robinson | Nurse Practitioner | Minute Clinic LLC | 2429 Martin Luther King Jr Swdr, Atlanta, GA 30311-1713 |
| Desiree N Rosant | Nurse Practitioner | Minute Clinic LLC | 2429 Martin Luther King Jr Swdr, Atlanta, GA 30311-1713 |
| Ronald C Jett Ii | Nurse Practitioner | Minute Clinic LLC | 2429 Martin Luther King Jr Swdr, Atlanta, GA 30311-1713 |
| Jennifer Francois | Family Medicine | Wellstar Medical Group, LLC | 3355 Cascade Rd Sw, Suite 100, Atlanta, GA 30311-3679 |
| Find all physicians in zip 30311 | |||
| City | ATLANTA |
| Zip Code | 30311 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ATLANTA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Modesta Tako.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.