PRIMARY CARE CLINICS OF GEORGIA (NPI# 1013961846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013961846 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE CLINICS OF GEORGIA |
| Practice Address |
1240 Jesse Jewell Pkwy Se Suite 370 Gainesville GA 30501-3862 |
| Mailing Address |
1240 Jesse Jewell Pkwy Se Suite 370 Gainesville GA 30501-3861 |
| Practice Telephone | 7705361004 |
| Practice Fax Number | 7705360905 |
| Mailing Telephone | 7705361004 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-07-21 |
| Authorized Official Name | DR. DAVID LEON HOCKER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7705361004 |
| Authorized Official Credential | M.D., M.R.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 041138 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | US DOL OWCP | 158736300 | 01 |
| GA | HEALTHLINK | 158736300 | 01 |
| GA | 000686463B | 05 | |
| GA | BLUE CROSS AND BLUE SHIEL | 1013961846 | 01 |
| GA | MEDICARE RAILROAD | P00089388 | 01 |
| Street Address |
1240 JESSE JEWELL PKWY SE SUITE 370 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879881 | C. Shane Bussler | Internal Medicine | 1240 Jesse Jewell Pkwy Se, Ste 500, Gainesville, GA 30501-3861 | 2005-05-23 |
| 1346780251 | Ashley Wilkins | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3862 | 2017-02-27 |
| 1962948422 | Charlsie A Thomas | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2017-01-09 |
| 1780128272 | Lauren H Darnell | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2016-12-19 |
| 1912452061 | Kristina Stefanova James | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 400, Gainesville, GA 30501-3862 | 2016-08-18 |
| 1124486238 | Brandon Lee Morrow | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Ste 300, Gainesville, GA 30501-3862 | 2016-02-03 |
| 1427413962 | Sherry Hope Flanagan | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2015-12-29 |
| 1457757593 | Colleen Mccoy | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Gainesville, GA 30501 | 2014-11-18 |
| 1689009953 | Ernie Loza Aldaco | Registered Nurse | 1240 Jesse Jewell Pkwy Se, Suite 300, Gainesville, GA 30501-3862 | 2013-09-05 |
| 1871838375 | Laura J Johansen | Physical Therapist | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2012-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| 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 |
|---|---|---|---|---|
| 1235756313 | Divine Destiny Virtual Health | Family Medicine | 2631a Nw 41st St, Gainesville, FL 32606-6628 | 2020-07-06 |
| 1407479702 | Heather Lynn Towne | Family Medicine | 4730 Nw 32nd Ave, Gainesville, FL 32606-6023 | 2020-05-20 |
| 1346883196 | Carehere LLC | Family Medicine | 4340 Newberry Rd Ste 203, Gainesville, FL 32607-2557 | 2019-10-24 |
| 1609348978 | Anderle and Lewis Pllc | Family Medicine | 1615 Hospital Blvd Ste A, Gainesville, TX 76240-2032 | 2018-12-26 |
| 1598111064 | Janelle C Wilkinson | Family Medicine | 1600 Sw Archer Road- Suite N1-07, University of Florida Community Health & Family Medicin, Gainesville, FL 32610-3001 | 2016-05-13 |
| 1033581996 | Florida Medical & Allergy Centers LLC | Family Medicine | 926 Nw 13th St, Gainesville, FL 32601-4140 | 2015-10-30 |
| 1255703419 | Patient First Richmond Medical Group Pllc | Family Medicine | 14800 Lee Highway, Gainesville, VA 20155-1842 | 2015-10-28 |
| 1962884411 | Margaret A Erwood | Family Medicine | 1439 Jesse Jewell Pkwy Ne Ste 102, Gainesville, GA 30501-3806 | 2015-06-22 |
| 1902286867 | Mehak Gandhi | Family Medicine | 6400 W Newberry Rd Ste 101, Gainesville, FL 32605-4383 | 2015-06-05 |
| 1497135263 | Peter Farag | Family Medicine | 6400 W Newberry Rd Ste 101b, Gainesville, FL 32605-6605 | 2015-06-05 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
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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.