NORTHSIDE EAR, NOSE & THROAT, PC (NPI# 1013071273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013071273 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE EAR, NOSE & THROAT, PC |
| Practice Address |
1360 Upper Hembree Rd 201 Roswell GA 30076-1171 |
| Mailing Address |
Po Box 933087 Atlanta GA 31193-3087 |
| Practice Telephone | 7704753361 |
| Practice Fax Number | 7706644431 |
| Mailing Telephone | 7704753361 |
| Mailing Fax Number | 7706644431 |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2008-09-11 |
| Authorized Official Name | ANDREW J DIAMOND (PRESIDENT) |
| Authorized Official Telephone | 7704753361 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | 059383 | GA | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
57545 | GA | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | 036368 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1360 UPPER HEMBREE RD 201 |
| City | ROSWELL |
| State | GA |
| Zip Code | 30076-1171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215928239 | Jennifer L. Tirino | Otolaryngology | 1360 Upper Hembree Rd, Suite 101, Roswell, GA 30076-1171 | 2005-10-31 |
| 1447698964 | Georgia Northside Ear, Nose and Throat, LLC | Otolaryngology | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1171 | 2013-06-06 |
| 1164664595 | Alpharetta Head and Neck Surgical Center, LLC | Clinic/Center | 1360 Upper Hembree Rd, Suite 202, Roswell, GA 30076-1171 | 2009-03-31 |
| 1699945311 | Thomas A. Johnson, Dds | Dentist | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1146 | 2008-03-10 |
| 1932312154 | Judy Spears | Audiologist | 1360 Upper Hembree Rd, 201, Roswell, GA 30076-1146 | 2007-05-07 |
| 1326251588 | Lesa Kagan | Audiologist | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1146 | 2007-05-07 |
| 1437290004 | Kshitij Vipin Majmundar | Specialist | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1146 | 2007-02-08 |
| 1821144221 | Alpharetta Women's Specialists | Obstetrics & Gynecology | 1360 Upper Hembree Rd, Suite # 101, Roswell, GA 30076-1146 | 2007-01-26 |
| 1316032881 | Samuel Lorenzo | Emergency Medicine | 1360 Upper Hembree Rd, Suite 100, Roswell, GA 30076-1171 | 2006-10-03 |
| 1356443089 | Thomas Chacko | Allergy & Immunology | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1146 | 2006-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1841776689 | Scott Gunter Brunson | Hearing Instrument Specialist | 777 Old Roswell Pl # E100, Roswell, GA 30076 | 2018-07-16 |
| 1861998197 | Daniel B Charek | Clinical Neuropsychologist | 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 | 2018-04-04 |
| 1427575554 | A One Home Care, Inc. | In Home Supportive Care | 1875 Old Alabama Road, Suite 420, Roswell, GA 30076 | 2017-08-29 |
| 1053836023 | Madelon Morgan | Counselor | 555 Sun Valley Dr Bldg F, Roswell, GA 30076 | 2017-08-10 |
| 1245769637 | Family Behavioral Health, LLC | Clinic/Center | 9275 Martin Rd, Roswell, GA 30076 | 2017-06-08 |
| 1093163750 | Ryann Soutar | Counselor | 702 Macy Dr, Roswell, GA 30076 | 2016-06-02 |
| 1447618707 | Concierge Medical Mgmt Group | Contractor | 760 Old Roswell Rd Ste 117, Roswell, GA 30076 | 2016-02-02 |
| 1063877710 | Augustine Young | Community/Behavioral Health | 427 Royal Creek Dr, Roswell, GA 30076 | 2015-12-23 |
| 1710360441 | Currents Massage LLC | Massage Therapist | 760 Old Roswell Road, Suite 230, Roswell, GA 30076 | 2015-06-30 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902908015 | Peter Bailey Md Pa | Otolaryngology | 313 W Country Club Road, Roswell, NM 88201 | 2006-09-01 |
| 1225090046 | Jan Delos Hobbs | Otolaryngology | 601 W Country Club Rd Ste 202, Roswell, NM 88201 | 2006-04-05 |
| 1225016454 | Keith Jackson | Otolaryngology | 1360 Upper Hembree Rd Ste 201b, Roswell, GA 30076-1230 | 2006-01-06 |
| 1447798715 | North Fulton Hearing Center LLC | Otolaryngology | 2500 Hospital Blvd, Suite 450, Roswell, GA 30076-4907 | 2017-02-07 |
| 1215255203 | Sunny Singh Khichi | Otolaryngology | 2500 Hospital Boulevard, Suite 450, Roswell, GA 30076-4919 | 2010-05-14 |
| 1093736613 | Vivek V. Gurudutt | Otolaryngology | 1360 Upper Hembree Rd, Suite 201b, Roswell, GA 30076-1171 | 2006-07-21 |
| 1477593168 | Peter Bailey | Otolaryngology | 313 W Country Club Rd, Suite 2, Roswell, NM 88201-5804 | 2006-06-08 |
| 1114905379 | Andrew Diamond | Otolaryngology | 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076-1171 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801402714 | Top Dog Solutions LLC | Otolaryngology | 4295 Interstate Dr Ste B, Macon, GA 31210-6815 | 2020-09-17 |
| 1164076600 | Oglethorpe Ear, Nose & Throat, LLC | Otolaryngology | 219 West Boggs Street, Lexington, GA 30648 | 2019-08-01 |
| 1154822971 | Coastal Ear, Nose & Throat | Otolaryngology | 200 Blue Moon Xing Ste 103, Pooler, GA 31322-9698 | 2018-02-27 |
| 1376928069 | Wiley A. Parker M.d PC | Otolaryngology | 5669 Peachtree Dunwoody Ste 295, Atlanta, GA 30342-1719 | 2015-07-23 |
| 1871970210 | North Atlanta Ear Nose & Throat PC | Otolaryngology | 4150 Deputy Bill Cantrell Memorial Dr., Suite 260, Cumming, GA 30040 | 2015-05-06 |
| 1235516741 | Alicia Bernstein | Otolaryngology | 3400c Old Milton Pkwy Ste 365, Alpharetta, GA 30005-4438 | 2015-05-04 |
| 1730576638 | Mark Arnold | Otolaryngology | 550 Peachtree St Ne Ste 1135550, Atlanta, GA 30308-2247 | 2015-04-20 |
| 1851789580 | William Lawrence Nicholson | Otolaryngology | 360 W 37th St, Sea Island, GA 31561-9748 | 2015-01-05 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1922413343 | Colin Wyatt Fuller | Otolaryngology | 1120 Fifteenth St, Bp-4109, Augusta, GA 30912 | 2014-06-24 |
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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.