REAGAN MEDICAL CENTER (NPI# 1003426628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003426628 |
| Entity Type | Organization |
| Organization Name | REAGAN MEDICAL CENTER |
| Practice Address |
1241 Friendship Rd Ste 110 Braselton GA 30517-5609 |
| Mailing Address |
2878 Five Forks Trickum Rd Ste 2a Lawrenceville GA 30044-5896 |
| Practice Telephone | 6783448700 |
| Mailing Telephone | 6783448700 |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | SATISH B PODDAR (MD) |
| Authorized Official Telephone | 6783448700 |
| Is Organization Subpart | Y |
| Parent Organization Name | REAGAN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457968372 | Reagan Medical Center | Neurological Surgery | 1295 Hembree Rd Ste 200, Roswell, GA 30076-5721 | 2020-09-24 |
| 1699388231 | Reagan Medical Center | Clinic/Center | 426 Exchange Blvd Ste 500, Bethlehem, GA 30620-1797 | 2020-08-24 |
| 1285255216 | Reagan Medical Center | Neurological Surgery | 11780 Northfall Ln, Alpharetta, GA 30009-7964 | 2020-04-30 |
| 1467771832 | Reagan Medical Center | Specialist | 10160 Medlock Bridge Rd, Suite 100, Johns Creek, GA 30097-4419 | 2010-05-25 |
| 1649365750 | Reagan Medical Center | Family Medicine | 2696 Lawrenceville Suwanee Rd, Suwanee, GA 30024-2535 | 2006-10-04 |
| 1952316747 | Reagan Medical Center | Neurological Surgery | 2878 Five Forks Trickum Rd, Ste 2a, Lawrenceville, GA 30044-5896 | 2006-07-30 |
| Street Address |
1241 FRIENDSHIP RD STE 110 |
| City | BRASELTON |
| State | GA |
| Zip Code | 30517-5609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124568423 | Specialty Orthopaedics, PC | Orthopaedic Surgery | 1241 Friendship Rd Ste 110, Braselton, GA 30517-5609 | 2017-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904076 | Northeast Georgia Dental Group | Dentist | 1205 Friendship Road, Braselton, GA 30517 | 2018-06-05 |
| 1548772544 | Shaniqua Lynee Sims | Nurse Practitioner | 1515 River Pl Ste 280, Braselton, GA 30517 | 2017-10-30 |
| 1538671847 | Georgia Pain and Wellness Center | Durable Medical Equipment & Medical Supplies | 1255 Frienship Road, Suite 150, Braselton, GA 30517 | 2017-10-26 |
| 1295137735 | Connie Johnson | Occupational Therapy Assistant | 5373 Thompsons Mill Rd., Braselton, GA 30517 | 2014-09-16 |
| 1780970921 | Christopher Thomas Middendorf | Hospitalist | 1400 River Place, Braselton, GA 30517 | 2011-06-27 |
| 1407140999 | Ashley Williams Zimmerman | Registered Nurse | 1515 River Pl Ste 340, Braselton, GA 30517 | 2011-06-02 |
| 1891097382 | Thu Mong Tran Nguyen | Dentist | 1702 Ammon Falls Ct, Braselton, GA 30517 | 2010-12-03 |
| 1053436030 | Andrew L Tam | Dentist | 5122 Hwy 53, Braselton, GA 30517 | 2007-03-20 |
| 1871503987 | Kathy Baxendale Morse | Nurse Practitioner | 2695 Old Winder Hwy, Suite 200, Pediatric Associates, Braselton, GA 30517 | 2006-08-09 |
| 1073585782 | Champak Patel | Legal Medicine | 5196 Hwy 53, Braselton, GA 30517 | 2006-02-06 |
| Find all providers in zip 30517 | ||||
| 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 |
|---|---|---|---|---|
| 1588284426 | Braselton Clinical Services | Family Medicine | 5745 Old Winder Hwy Ste G, Braselton, GA 30517-1637 | 2020-04-21 |
| 1437306370 | Anointed Hands Medical Service | Family Medicine | 1215 Tuscany Dr Ste A, Braselton, GA 30517-3488 | 2008-08-21 |
| 1194717421 | Rebecca J. Loomis | Family Medicine | 1515 River Pl Ste 100, Braselton, GA 30517-5610 | 2005-08-23 |
| 1386112936 | Jennifer Lee King | Family Medicine | 32 Johnson Dr, Lol, Braselton, GA 30517-2774 | 2018-11-12 |
| 1790196749 | Sakib Maya | Family Medicine | 1515 River Pl Ste 100, Braselton, GA 30517-5610 | 2014-05-13 |
| 1801206131 | Saloni N Patel | Family Medicine | 1515 River Pl Ste 200, Braselton, GA 30517-5603 | 2014-05-08 |
| 1538470646 | Omari Asim Hodge | Family Medicine | 1400 River Pl, Braselton, GA 30517-5600 | 2010-06-24 |
| 1255437075 | Haritha Arikatla | Family Medicine | 1515 River Pl, Suit 200, Braselton, GA 30517-5602 | 2006-09-16 |
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|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1831706217 | Veronica Vante | Family Medicine | 200 Business Center Dr Ste 204, Stockbridge, GA 30281-9025 | 2020-09-29 |
| 1912514969 | Oasis Healthcare Service | Family Medicine | 2195 Pace St Ste E, Covington, GA 30014-6657 | 2020-09-24 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1598377319 | Renee Green Lewis | Family Medicine | 9 Bluelake Blvd, Pooler, GA 31322-9617 | 2020-08-21 |
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1407464084 | Railyard Family Medicine LLC | Family Medicine | 416 Grayson Pkwy, Grayson, GA 30017-1220 | 2020-07-20 |
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1992323398 | Careperks LLC | Family Medicine | 4936 Presidents Way, Tucker, GA 30084-3038 | 2020-07-12 |
| Find all providers with the same taxonomy | ||||
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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.