EASTSIDE MEDSPA AND FAMILY PRACTICE INC. (NPI# 1154330348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154330348 |
| Entity Type | Organization |
| Organization Name | EASTSIDE MEDSPA AND FAMILY PRACTICE INC. |
| Practice Address |
7138 Highway 212 Suite D Covington GA 30016-8047 |
| Mailing Address |
2320 Haflinger Cir Conyers GA 30012-5292 |
| Practice Telephone | 7706795238 |
| Mailing Telephone | 7726183133 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SONIA ANDREA BROWN (PRESIDENT) |
| Authorized Official Telephone | 7726183133 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
057439 | GA | Ambulatory Health Care Facilities |
| Street Address |
7138 HIGHWAY 212 SUITE D |
| City | COVINGTON |
| State | GA |
| Zip Code | 30016-8047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922012269 | Ghazala Khalid | Pediatrics | 7138 Highway 212, C, Covington, GA 30016-8047 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565605 | Katrina Williams | Case Manager/Care Coordinator | 220 Meadowidge Dr, Covington, GA 30016 | 2019-08-28 |
| 1407322134 | Mali Rice | Registered Nurse | 105 Syracuse Lane, Covington, GA 30016 | 2018-10-20 |
| 1619452927 | Angelina Jones | Contractor | 290 Piedmont Circle, Covington, GA 30016 | 2018-10-02 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1922538529 | Tisha Owes | Home Health | 110 Trinity Dr, Covington, GA 30016 | 2017-06-15 |
| 1053868695 | Delhia Assanah IIi | Counselor | 101 Kirkland Road, Covington, GA 30016 | 2016-09-01 |
| 1760834295 | Resurgens East Surgery Center, LLC | Clinic/Center | 3241 Iris Dr, Suite 100, Covington, GA 30016 | 2016-07-08 |
| 1528443371 | Latoya N Wright | Counselor | 100 Winnstead Place, Covington, GA 30016 | 2015-07-22 |
| 1598157307 | Sierra Private Homecare, Inc. | Adult Companion | 75 Cinnamon Oak Circle, Covington, GA 30016 | 2015-03-03 |
| 1326391079 | Lana Abiola Fraser | Nurse's Aide | 840 Oakhill Road, Covington, GA 30016 | 2012-10-18 |
| Find all providers in zip 30016 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1639720030 | Careatc | Clinic/Center | 899 Hope St, Covington, TN 38019-1805 | 2019-09-26 |
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| 1932641669 | The Family Practice At Northshore Counseling and Wellness, LLC | Clinic/Center | 201 Holiday Blvd, Suite 120, Covington, LA 70433-5088 | 2016-11-11 |
| 1093150468 | Covington Pediatrics, Pllc | Clinic/Center | 411 W Riverside St, Covington, VA 24426-1273 | 2013-04-30 |
| 1538400031 | Covington Chiropractic LLC | Clinic/Center | 26708 180th Ave Se, Suite102, Covington, WA 98042-4969 | 2013-03-07 |
| 1073693958 | Northlake Medicine and Wellness Center, LLC | Clinic/Center | 1980 N Highway 190, Covington, LA 70433-5158 | 2006-10-16 |
| Find all providers in COVINGTON | ||||
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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.