NELLY MIZRAHI (NPI# 1104927565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104927565 |
| Entity Type | Individual |
| Full Name | NELLY MIZRAHI |
| Credential | M.D. |
| Practice Address |
4855 River Green Pkwy Suite 700 Duluth GA 30096-8336 |
| Practice Telephone | 7706220880 |
| Practice Fax Number | 7706229875 |
| Mailing Telephone | 7706220880 |
| Mailing Fax Number | 7706229875 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2010-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 058545 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 170546490A | 05 | |
| GA | GA LICENSE | 058545 | 01 |
| Street Address |
4855 RIVER GREEN PKWY SUITE 700 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-8336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487688438 | The Vein Doctor, LLC | Internal Medicine | 4855 River Green Pkwy, Suite 140, Duluth, GA 30096-8336 | 2006-07-10 |
| 1104292630 | Lifeline Primary Care, Inc | Family Medicine | 4855 River Green Pkwy, Building 7, Suite 700, Duluth, GA 30096-8336 | 2015-08-19 |
| 1992055198 | Youngshin Health LLC | Acupuncturist | 4855 River Green Pkwy, Suite 130, Duluth, GA 30096-8336 | 2012-09-14 |
| 1790031011 | Arlene L Salmon | Physician Assistant | 4855 River Green Pkwy, Suite 700, Duluth, GA 30096-8336 | 2012-07-24 |
| 1861790743 | Saerom Physical Therapy, Inc | Physical Therapist | 4855 River Green Pkwy, Suite 110, Duluth, GA 30096-8336 | 2011-03-02 |
| 1689803959 | Kavita Reddy Gone | Family Medicine | 4855 River Green Pkwy, Duluth, GA 30096-8336 | 2009-07-08 |
| 1497926083 | C.a.r.e. Pediatrics, LLC | Clinic/Center | 4855 River Green Pkwy, Suite 610, Duluth, GA 30096-8336 | 2008-03-21 |
| 1447438874 | Young Won Kang M.d. P.C. | Clinic/Center | 4855 River Green Pkwy, #140, Duluth, GA 30096-8336 | 2008-02-07 |
| 1821297920 | Evergreen Primary Care, PC | Internal Medicine | 4855 River Green Pkwy, Suite 520, Duluth, GA 30096-8336 | 2007-07-17 |
| 1841357696 | Boyle and Toth Family Medicine, L.L.C. | Family Medicine | 4855 River Green Pkwy, Suite 700, Duluth, GA 30096-8336 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 1811553084 | Clement Ayanbadejo LLC | Family Medicine | 2282 Meadow Church Rd Ste 200, Duluth, GA 30097-5318 | 2019-05-14 |
| 1902391923 | Young-tae Kim | Family Medicine | 3610 Peachtree Industrial Blvd Ste 100, Duluth, GA 30096-5139 | 2018-06-22 |
| 1659655538 | Primary Care of Atlanta | Family Medicine | 4124 Chattahoochee Trce, Ste 103, Duluth, GA 30097-2147 | 2011-10-10 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1497087126 | St. Luke's Hospital of Duluth | Family Medicine | 6351 E. Superior St., Duluth, MN 55804-2545 | 2010-02-05 |
| 1861729816 | Mark Steven Grimsley | Family Medicine | 1611 Satellite Blvd Ste 3, Duluth, GA 30097 | 2009-11-12 |
| 1154552990 | Clement O Ayanbadejo | Family Medicine | 2282 Meadow Church Rd, Ste 200, Duluth, GA 30097-5318 | 2009-07-28 |
| 1891950457 | Liem Chi Ngo | Family Medicine | 4470 Satellite Blvd, Suite 204, Duluth, GA 30096-8851 | 2008-07-23 |
| 1962663302 | Martin Charles Hinz | Family Medicine | 1150 88th Ave W, Duluth, MN 55808-1505 | 2008-06-18 |
| 1447422506 | Onelio Emilio Perdomo | Family Medicine | 3750 Venture Drive, Suite 130, Duluth, GA 30096-1808 | 2008-03-28 |
| Find all providers in DULUTH | ||||
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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.