MEDPRIME BROOKHAVEN (NPI# 1205288164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205288164 |
| Entity Type | Organization |
| Organization Name | MEDPRIME BROOKHAVEN |
| Practice Address |
2 Concourse Pkwy Suite 100 Atlanta GA 30328-5371 |
| Mailing Address |
1100 Peachtree St Ne Suite 200 Atlanta GA 30309-4501 |
| Practice Telephone | 6786918239 |
| Mailing Telephone | 6786918239 |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2016-07-04 |
| Authorized Official Name | SHERWIN EUGENE BRYANT (COMPLIANCE OFFICER) |
| Authorized Official Telephone | 6786918239 |
| Authorized Official Credential | MHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 61430 | GA | Managed Care Organizations |
| Street Address |
2 CONCOURSE PKWY SUITE 100 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328-5371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
| Find all providers in zip 30328 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578003349 | Lrdj LLC | Preferred Provider Organization | 790 Huff Rd Nw Apt 4055, Atlanta, GA 30318-4373 | 2017-02-27 |
| 1588052641 | Bjmm Medical LLC | Preferred Provider Organization | 1287 Glenwood Ave Se Ste C, Atlanta, GA 30316-1932 | 2014-12-24 |
| 1982955902 | Melson Counseling & Consulting Group | Preferred Provider Organization | 2900 Chamblee Tucker Rd Bldg 5-300, Atlanta, GA 30341-4158 | 2012-10-01 |
| 1013296078 | Peachtree Spine Center | Preferred Provider Organization | 1401 Peachtree St Ne Ste 160, Atlanta, GA 30309-3000 | 2011-08-09 |
| 1588812465 | Applications Technology Group, Inc. | Preferred Provider Organization | 5825 Glenridge Dr Ne Bldg 3, Atlanta, GA 30328-5387 | 2008-09-04 |
| 1851439830 | Dr.lily Narusevicius | Preferred Provider Organization | 4890 Roswell Rd Ne Ste 100, Atlanta, GA 30342-2606 | 2007-02-02 |
| 1679680557 | Nicholas Jean Beaulieu | Preferred Provider Organization | 920 Ponce De Leon Ave Ne, 920 Ponce De Leon Ave, Atlanta, GA 30306-4212 | 2006-08-24 |
| 1407365224 | Ascension Wellness Inc | Preferred Provider Organization | 1800 Peachtree St Nw Ste 660, Atlanta, GA 30309-2522 | 2017-09-25 |
| 1538559729 | Mind's Eye Enterprises, LLC | Preferred Provider Organization | 455 E Paces Ferry Rd Ne, Suite 332, Atlanta, GA 30305-3313 | 2015-01-27 |
| 1699199554 | Care Choice Adult Development Program Inc | Preferred Provider Organization | 1075 Peachtree St Ne Ste 3650, Atlanta, GA 30309-3934 | 2014-02-13 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on MEDPRIME BROOKHAVEN.
| 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.