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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
Street Address |
1105 N 5TH AVE NE |
City | ROME |
State | GA |
Zip Code | 30165-2603 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033315122 | Suni Hamm Carroll | Nurse Practitioner | 1105 N 5th Ave Ne, Rome, GA 30165-2603 | 2007-06-25 |
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 |
Find all providers in zip 30165 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
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). |
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 |
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1518585868 | Robin June Dc, LLC | Clinic/Center | 400 Embassy Row Ste 110, Sandy Springs, GA 30328-5723 | 2020-07-13 |
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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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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.