COMMUNITY NEUROLOGICAL CLINIC (NPI# 1164614608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164614608 |
| Entity Type | Organization |
| Organization Name | COMMUNITY NEUROLOGICAL CLINIC |
| Practice Address |
3400 Mcclure Bridge Rd Suite D401 Duluth GA 30096-6675 |
| Practice Telephone | 7706222230 |
| Practice Fax Number | 7706229741 |
| Mailing Telephone | 7706222230 |
| Mailing Fax Number | 7706229741 |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2009-01-23 |
| Authorized Official Name | DR. PHILIP R KENNEDY (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 7706222230 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | GA039708 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000772813A | 05 |
| Street Address |
3400 MCCLURE BRIDGE RD SUITE D401 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-6675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903485 | Philip R Kennedy | Psychiatry & Neurology | 3400 Mcclure Bridge Rd, Suite D401, Duluth, GA 30096-6675 | 2005-06-21 |
| 1063860740 | Alpha Recovery Group Inc | Health Maintenance Organization | 3400 Mcclure Bridge Rd, Building C, Suit A&b, Duluth, GA 30096-6675 | 2016-06-02 |
| 1679960884 | Allys Sernior Services, Inc. | Health Maintenance Organization | 3400 Mcclure Bridge Rd, Building C-301, Duluth, GA 30096-6675 | 2015-04-26 |
| 1972889491 | Hand To Shoulder Therapy Specialists of Duluth | Occupational Therapist | 3400 Mcclure Bridge Rd, F601, Duluth, GA 30096-6675 | 2011-10-28 |
| 1154586667 | Mbs Connection LLC | Clinic/Center | 3400 Mcclure Bridge Rd, Bldg F, Ste A, Duluth, GA 30096-6675 | 2008-07-24 |
| 1285793372 | Glen C Mcintosh | Dentist | 3400 Mcclure Bridge Rd, Building G, Suite B, Duluth, GA 30096-6675 | 2006-12-06 |
| 1871688317 | James Clinton Cronan Jr. | Plastic Surgery | 3400 Mcclure Bridge Rd, Building B201, Duluth, GA 30096-6675 | 2006-10-03 |
| 1902818032 | Michelle Morante | Physician Assistant | 3400 Mcclure Bridge Rd, Building B, Duluth, GA 30096-6675 | 2006-08-13 |
| 1578574455 | Choice Chiropractic and Wellness, Inc. | Chiropractor | 3400 Mcclure Bridge Rd, Building B, Suite C, Duluth, GA 30096-6675 | 2006-08-10 |
| 1417977885 | Surgical Assistants of America, Inc. | Physician Assistant | 3400 Mcclure Bridge Rd, Building B201, Duluth, GA 30096-6675 | 2006-07-20 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327415 | Julie Baker | Specialist | 907 W Central Entrance, Duluth, MN 55811-5469 | 2020-05-07 |
| 1942510904 | Amanda Rose Kerola | Specialist | 2814 Minnesota Ave, Duluth, MN 55802-2526 | 2010-10-08 |
| 1639323827 | Elegant Touch Massage Therapy | Specialist | 2590 Peachtree Industrial Blvd Ste D, Duluth, GA 30097-3405 | 2008-11-14 |
| 1003089418 | Gwinnett Multi Specialty Group LLC | Specialist | 3840 Peachtree Industrial Boulevard, Duluth, GA 30096-4847 | 2008-04-07 |
| 1790954279 | Generations Health Care Initiative Inc | Specialist | 5 N 3rd Ave W, Suite 310, Duluth, MN 55802 | 2008-02-28 |
| 1912067877 | Barbara Joy Bergstrom | Specialist | 4505 W Superior St, Duluth, MN 55807-2728 | 2006-12-11 |
| 1851474506 | Heide's Mastectomy Services of Duluth. | Specialist | 701 1/2 North 6th Ave. East, Duluth, MN 55805-1333 | 2006-10-23 |
| 1447342241 | Advanced Prosthetics Inc | Specialist | 3540 Duluth Park Lane, Suite 230, Duluth, GA 30096 | 2006-09-29 |
| 1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
| 1932125820 | Northland Urology Asso. P.a. | Specialist | 1000 E 1st St Ste 306, Duluth, MN 55805-2297 | 2006-07-14 |
| 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.