SYNERGY MEDICAL CENTERS OF ROSWELL, LLC (NPI# 1215136890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215136890 |
| Entity Type | Organization |
| Organization Name | SYNERGY MEDICAL CENTERS OF ROSWELL, LLC |
| Practice Address |
5499 Jonesboro Rd Suite 240 Lake City GA 30260-3553 |
| Mailing Address |
1065 Bridge Mill Ave Canton GA 30114-7717 |
| Practice Telephone | 7708812191 |
| Practice Fax Number | 7707041884 |
| Mailing Telephone | 7705812191 |
| Mailing Fax Number | 7707041884 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2015-07-21 |
| Authorized Official Name | DR. CHRISTINE M FALLER (OFFICE MANAGER) |
| Authorized Official Telephone | 7705812191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | CHIR008003 | GA | Chiropractic Providers |
| N | 174400000X | Specialist | PT006876 | GA | Other Service Providers |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
22393 | GA | Allopathic & Osteopathic Physicians |
| Y | 174400000X | Specialist | 56072 | GA | Other Service Providers |
| Street Address |
5499 JONESBORO RD SUITE 240 |
| City | LAKE CITY |
| State | GA |
| Zip Code | 30260-3553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376618793 | Charles Watts | Chiropractor | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2006-11-21 |
| 1063967842 | Timothy Mcknight | Ambulance | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2016-08-22 |
| 1811370174 | Members Ems | Ambulance | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2015-07-06 |
| 1952634909 | Lacy Medical Services LLC | Specialist | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2009-09-09 |
| 1043495427 | Advanced Medical Clinics, P.C. | General Practice | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2008-01-04 |
| 1053486456 | Dawn Wilson | Family Medicine | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2006-11-21 |
| 1003981416 | John Parlier | Chiropractor | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| 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 |
|---|---|---|---|---|
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| 1437579372 | Shara Evans | Specialist | 501 Nw Lake City Ave, Apt 103, Lake City, FL 32055 | 2014-04-18 |
| 1073959136 | Vernon Taylor Smith | Specialist | 2537 Elk Road, Lake City, CO 81235 | 2013-05-16 |
| 1346478989 | Tiffani Mote | Specialist | 315 Sw Pheasant Way, Lake City, FL 32024-1146 | 2009-06-22 |
| 1972790517 | Jorga Snyder Duran | Specialist | 214 Se Tribble St, Lake City, FL 32025-0108 | 2007-09-27 |
| 1326239179 | Michelle Caroline Hatton | Specialist | 4852 S Us Highway 441, Lake City, FL 32025-0310 | 2007-08-07 |
| 1023210986 | North Fl Arthritis Clinic, Pa. | Specialist | 4551 W Est Us 90, Suite 102, Lake City, FL 32055 | 2007-06-04 |
| 1023102555 | Pastor H. Rios, Md | Specialist | 449 Se Baya Drive, Lake City, FL 32025 | 2006-10-02 |
| 1447352760 | Juan R Baralt | Specialist | 619 South Marion, Lake City, FL 32025-5808 | 2006-09-05 |
| 1457376055 | William Clark Griggs | Specialist | 238 East Main Street, Lake City, SC 29560 | 2006-07-13 |
| Find all providers in LAKE CITY | ||||
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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.