NORTHWEST GEORGIA MEDICAL CLINIC 2LLC


Address: 1105 N 5th Ave Ne, Rome, GA 30165-2603
Phone: 4049430205

NORTHWEST GEORGIA MEDICAL CLINIC 2LLC (NPI# 1053511493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053511493
Entity Type Organization
Organization Name NORTHWEST GEORGIA MEDICAL CLINIC 2LLC
Practice Address 1105 N 5th Ave Ne
Rome
GA 30165-2603
Mailing Address Po Box 468329
Atlanta
GA 31146-8329
Practice Telephone 4049430205
Enumeration Date 2007-07-24
Last Update Date 2007-07-24
Authorized Official Name ALICIA HOLDEN (LEAD)
Authorized Official Telephone 4049430205
Authorized Official Credential ACCOUNTING
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Office Location

Street Address 1105 N 5TH AVE NE
City ROME
State GA
Zip Code 30165-2603

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033315122 Suni Hamm Carroll Nurse Practitioner 1105 N 5th Ave Ne, Rome, GA 30165-2603 2007-06-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346868775 Heather Bowman Physical Therapist 600 Eagle, E Lake Dr, Rome, GA 30165 2020-07-13
1205451101 Kristopher Nelson Student in an Organized Health Care Education/Training Program 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 2020-06-16
1962061457 Stuart Paul Shaklee Occupational Therapy Assistant 1356 Redmond Road, Rome, GA 30165 2019-06-10
1386001055 Autumn Streetman Counselor 6 Mathis Drive, Rome, GA 30165 2016-01-26
1144695784 Gabrador Milligan Counselor 6 Mathis Road, Rome, GA 30165 2015-12-08
1386041952 Theresa Suits Registered Nurse 1 Woodbine Avenue, Rome, GA 30165 2014-11-26
1942561147 Nicole C. Christian Clinical Neuropsychologist 305 Redmond Rd, Rome, GA 30165 2012-06-04
1679832711 Niki Pareshkumar Bhavsar Internal Medicine 3041 Turner Mccall Blvd, Rome, GA 30165 2012-05-10
1285927491 Amanda Fischer Reeves Family Medicine 304 Shorter Ave Nw Ste 102, Rome, GA 30165 2011-05-20
1033436647 Northland Hearing Centers, Inc. Hearing Instrument Specialist 4 Coosawattee Ave, Rome, GA 30165 2010-04-23
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164783270 Center for Neurocognitive Assessment and Rehabilitation, PC Clinic/Center 512 Riverside Pkwy Ne Ste 300, Rome, GA 30161-2939 2012-06-05
1053556365 New Horizons Treatment Center Inc. Clinic/Center 36 Chateau Ct Se, Rome, GA 30161-7264 2008-12-16
1356689004 Rome Memorial Hospital, Inc Clinic/Center 1500 N James St, Rome, NY 13440-2844 2013-01-30
1497886253 Robin Scoggin, Od, Inc. Clinic/Center 203 Glenn Milner Blvd, Rome, GA 30161-3239 2007-03-07
1710042734 Primary Healthcare of Ashtabula Clinic/Center 5266 State Route 45, Rome, OH 44085-9404 2006-12-27
1780697284 Affordable Health Care, LLC Clinic/Center 315 W 10th St Ne, Suite 110, Rome, GA 30165-2638 2006-08-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1619578820 Pinpoint Covid Testing Inc Clinic/Center 3075 Tower Rd Ste A, Columbus, GA 31909-2537 2020-11-04
1194331439 Shittu Family Practice,llc Clinic/Center 11679 Bruce Dr, Hampton, GA 30228-4008 2020-09-22
1154937050 Staywellatl,llc Clinic/Center 2550 Heritage Ct Se Ste 135, Atlanta, GA 30339-3528 2020-09-17
1164035564 The Lotus Haven PC Clinic/Center 950 Dannon Vw Sw Ste 4101, Atlanta, GA 30331-2159 2020-08-25
1518585868 Robin June Dc, LLC Clinic/Center 400 Embassy Row Ste 110, Sandy Springs, GA 30328-5723 2020-07-13
1740808773 All Test Services Clinic/Center 575 Sigman Rd Ne, Conyers, GA 30013-1311 2020-07-07
1134741580 Knowles Exams & More Clinic/Center 123 Glyndale Dr Ste 107, Brunswick, GA 31520-1404 2020-05-08
1558981985 Elite Mens' Health, LLC Clinic/Center 3361 Nottinghill Ln, Valdosta, GA 31605-5874 2020-04-27
1447886320 Momentum Rehab & Therapy Clinic/Center 5349 Snapfinger Woods Dr, Decatur, GA 30035-4028 2020-03-23
1073146759 Transitional Care Clinic LLC Clinic/Center 2084 Newnan Crossing Blvd E Ste 300, Newnan, GA 30265-2561 2020-02-20
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Competitor

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City ROME
Zip Code 30165

Improve Information

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Dataset Information

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.

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