SOUTH METRO IMMEDIATE CARE CENTER (NPI# 1053420109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053420109 |
| Entity Type | Organization |
| Organization Name | SOUTH METRO IMMEDIATE CARE CENTER |
| Practice Address |
2841 Greenbriar Pkwy Sw Suite 126 Atlanta GA 30331-2620 |
| Practice Telephone | 4043467162 |
| Practice Fax Number | 4043467207 |
| Mailing Telephone | 4043467162 |
| Mailing Fax Number | 4043467207 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HELENA K BENTLEY (OWNER) |
| Authorized Official Telephone | 404-346-7162 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146L00000X | Emergency Medical Technician, Paramedic | 27494 | GA | Emergency Medical Service Providers |
| Street Address |
2841 GREENBRIAR PKWY SW SUITE 126 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316180649 | Emory Dialysis, LLC | Clinic/Center | 2841 Greenbriar Pkwy Sw, X126, Atlanta, GA 30331-2620 | 2009-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| Taxonomy Code | 146L00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Paramedic |
| An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153997 | Hosie L Baugh | Emergency Medical Technician, Paramedic | 400 Rock Meadow Dr, Stone Mtn, GA 30088-1508 | 2020-10-26 |
| 1437778883 | Metro Staffing Agency, LLC | Emergency Medical Technician, Paramedic | 1109 Medical Center Dr Ste 4, Augusta, GA 30909-6641 | 2020-04-15 |
| 1841849486 | Angela Michelle Brown | Emergency Medical Technician, Paramedic | 202 Thomson Hwy Ste C, Wrens, GA 30833-1215 | 2019-09-06 |
| 1194372201 | Desmond Newkirk | Emergency Medical Technician, Paramedic | 185 Bradford Sq Ste C, Fayetteville, GA 30215-1932 | 2019-08-22 |
| 1215426705 | Andrew Butler | Emergency Medical Technician, Paramedic | 32 Twin Oaks Pl, Savannah, GA 31407-5100 | 2018-05-09 |
| 1144735051 | Michael Scott Green | Emergency Medical Technician, Paramedic | 315 Heathrow Dr, Hiram, GA 30141-2341 | 2017-12-14 |
| 1568818342 | Mark Hulsey | Emergency Medical Technician, Paramedic | 3455 Leisure Ln, Gainesville, GA 30506-3715 | 2016-05-10 |
| 1639553555 | Michelle Sturdivant | Emergency Medical Technician, Paramedic | 95 Summer Lake Cv, Dallas, GA 30157-7617 | 2015-07-10 |
| 1669854519 | Dennis Middlebrooks | Emergency Medical Technician, Paramedic | 2917 Valley Ridge Dr, Decatur, GA 30032-5714 | 2015-06-26 |
| 1962895946 | Courtnei Williams | Emergency Medical Technician, Paramedic | 4267 Chamblee Tucker Rd, Tucker, GA 30084 | 2015-03-14 |
| 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.