NORTHEAST GEORGIA PHYSICIANS GROUP, INC. (NPI# 1134749211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134749211 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA PHYSICIANS GROUP, INC. |
| Practice Address |
1515 River Pl Ste 380 Braselton GA 30517-5605 |
| Practice Telephone | 7708489345 |
| Mailing Telephone | 7708489345 |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | SHELBY ANN DODD (EXECUTIVE DIRECTOR PHYSICIAN SERVIC) |
| Authorized Official Telephone | 7702198453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104009059 | Northeast Georgia Physicians Group, Inc. | Family Medicine | 115 Towne Center Pkwy, Suite 113, Hoschton, GA 30548-2213 | 2007-12-14 |
| 1538103049 | Northeast Georgia Physicians Group, Inc. | Non-emergency Medical Transport (VAN) | 665 Lanier Park Dr, Gainesville, GA 30501-2059 | 2006-06-15 |
| 1699395772 | Northeast Georgia Physicians Group, Inc. | Allergy & Immunology | 2510 Limestone Pkwy, Gainesville, GA 30501-2089 | 2020-04-20 |
| 1891745212 | Northeast Georgia Physicians Group, Inc. | Psychiatry & Neurology | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-05-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHEAST GEORGIA PHYSICIANS GROUP, INC. | 601 S Enota Dr Ne Ste P, Gainesville, GA 30501-2544 |
| Street Address |
1515 RIVER PL STE 380 |
| City | BRASELTON |
| State | GA |
| Zip Code | 30517-5605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063904076 | Northeast Georgia Dental Group | Dentist | 1205 Friendship Road, Braselton, GA 30517 | 2018-06-05 |
| 1548772544 | Shaniqua Lynee Sims | Nurse Practitioner | 1515 River Pl Ste 280, Braselton, GA 30517 | 2017-10-30 |
| 1538671847 | Georgia Pain and Wellness Center | Durable Medical Equipment & Medical Supplies | 1255 Frienship Road, Suite 150, Braselton, GA 30517 | 2017-10-26 |
| 1295137735 | Connie Johnson | Occupational Therapy Assistant | 5373 Thompsons Mill Rd., Braselton, GA 30517 | 2014-09-16 |
| 1780970921 | Christopher Thomas Middendorf | Hospitalist | 1400 River Place, Braselton, GA 30517 | 2011-06-27 |
| 1407140999 | Ashley Williams Zimmerman | Registered Nurse | 1515 River Pl Ste 340, Braselton, GA 30517 | 2011-06-02 |
| 1891097382 | Thu Mong Tran Nguyen | Dentist | 1702 Ammon Falls Ct, Braselton, GA 30517 | 2010-12-03 |
| 1053436030 | Andrew L Tam | Dentist | 5122 Hwy 53, Braselton, GA 30517 | 2007-03-20 |
| 1871503987 | Kathy Baxendale Morse | Nurse Practitioner | 2695 Old Winder Hwy, Suite 200, Pediatric Associates, Braselton, GA 30517 | 2006-08-09 |
| 1073585782 | Champak Patel | Legal Medicine | 5196 Hwy 53, Braselton, GA 30517 | 2006-02-06 |
| Find all providers in zip 30517 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215597828 | The Coble Group, LLC | Allergy & Immunology | 3875 Roland Hayes Pkwy Sw, Calhoun, GA 30701-7501 | 2019-06-17 |
| 1932683083 | Quick Care Diagnostics LLC | Allergy & Immunology | 4760 Austell Rd Ste 7, Austell, GA 30106-2007 | 2018-09-24 |
| 1679075873 | Atlanta Wide Mobile Testing, LLC | Allergy & Immunology | 2215 Cheshire Bridge Rd Ne Ste C, Atlanta, GA 30324-4234 | 2018-03-02 |
| 1669986709 | Thomas Chacko M.d. P.c | Allergy & Immunology | 330 Newcastle Dr, Alpharetta, GA 30009-7162 | 2017-11-28 |
| 1053868083 | Savannah Respiratory and Allergy Associates, P.C. | Allergy & Immunology | 1 Mulberry Bluff Dr, Savannah, GA 31406-3270 | 2016-09-07 |
| 1356616338 | Eleven 11 Medical Management, LLC | Allergy & Immunology | 438 Henry Ford II Ave, Hapeville, GA 30354-1622 | 2012-03-09 |
| 1972871960 | Haeja K. Jung | Allergy & Immunology | 9175 Etching Overlook, Johns Creek, GA 30097 | 2011-12-06 |
| 1295012631 | Southeast Asthma and Allergy Center, PC | Allergy & Immunology | 511 Gordon Ave, Thomasville, GA 31792-6645 | 2011-11-14 |
| 1225340540 | Adesh D. Patel | Allergy & Immunology | 3300 Old Milton Pkwy Ste 125, Alpharetta, GA 30005-2426 | 2010-07-02 |
| 1326119918 | Gregg Robert Sachs | Allergy & Immunology | 5555 Peachtree Dunwoody Rd Ste 125, Atlanta, GA 30342-1710 | 2006-11-13 |
| 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.