ATLANTA VA MEDICAL CENTER (NPI# 1255362729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255362729 |
| Entity Type | Organization |
| Organization Name | ATLANTA VA MEDICAL CENTER |
| Practice Address |
1670 Clairmont Rd Atlanta Va Decatur GA 30033-4004 |
| Mailing Address |
4366 Idlewood Ln Tucker GA 30084-6437 |
| Practice Telephone | 4043216111 |
| Mailing Telephone | 7707128249 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-11-04 |
| Authorized Official Name | MR. ROBERT RAY ALEXANDER (NURSE PRACTIONER) |
| Authorized Official Telephone | 4043216111 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
RN 096164-NP | GA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811391691 | Atlanta Va Medical Center | Nursing Facility/Intermediate Care Facility | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2014-10-22 |
| 1093990731 | Atlanta Va Medical Center | General Acute Care Hospital | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2007-12-31 |
| 1073699286 | Atlanta Va Medical Center | Clinic/Center | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-10-31 |
| 1306874219 | Atlanta Va Medical Center | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-06-29 |
| 1265477863 | Atlanta Va Medical Center | Nursing Facility/Intermediate Care Facility | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-06-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ATLANTA VA MEDICAL CENTER | 1670 Clairmont Road, Decatur, GA 30033-4004 |
| Street Address |
1670 CLAIRMONT RD ATLANTA VA |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342042 | Ketayoun Davari | Pharmacist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2005-08-03 |
| 1730780073 | Mojisola Mary Bakare | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-11-03 |
| 1346849189 | Jessica Astrid George | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-10-22 |
| 1841807591 | Mallorie Gayle Carroll | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-28 |
| 1164036570 | Rachel Heatherly | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-09-02 |
| 1679186670 | Martale Jerrell Davis | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-28 |
| 1619580206 | Rosetta Yvette Delancy | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-25 |
| 1760095186 | Alaisha Delane Wellons | Social Worker | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-25 |
| 1568074797 | Hannah F Martyn | Psychologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-19 |
| 1285245308 | Meera Gupta | Pharmacist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871981084 | Atlanta Vamc | Clinic/Center | 755 Commerce Drive, Suite 700, Decatur, GA 30030-2621 | 2014-12-23 |
| 1124071881 | Danville Vamc | Clinic/Center | 792 N Sunnyside Rd, Decatur, IL 62522-1156 | 2006-05-17 |
| 1013395102 | Atlanta Vamc | Clinic/Center | 250 N Arcadia Ave, Decatur, GA 30030-2115 | 2015-05-11 |
| 1538398656 | Department of Veterans Affairs | Clinic/Center | 3035 E Mound Rd, Decatur, IL 62526-9650 | 2009-07-10 |
| 1073699286 | Atlanta Va Medical Center | Clinic/Center | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-10-31 |
| 1366498776 | Atlanta Midtown Va Clinic | Clinic/Center | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-05-26 |
| 1568417087 | Dallas Vamc | Clinic/Center | 1713 S Fm 51, Decatur, TX 76234-3642 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333649 | Atlanta Vamc | Clinic/Center | 2309 Parklake Dr Ne, Atlanta, GA 30345-2914 | 2019-09-03 |
| 1962050286 | Atlanta Vamc | Clinic/Center | 934 E Church St, Jasper, GA 30143-1926 | 2019-08-29 |
| 1811545130 | Atlanta Vamc | Clinic/Center | 1800 Phoenix Blvd Ste 100, College Park, GA 30349-6055 | 2019-08-29 |
| 1811551633 | Atlanta Vamc | Clinic/Center | 2217 Roswell Rd Ste 114, Marietta, GA 30062-2957 | 2019-04-26 |
| 1982074720 | Montgomery Vamc | Clinic/Center | 6635 Bass Road, Bldg. 9214, Fort Benning, GA 31905-9998 | 2015-10-06 |
| 1174911200 | Atlanta Vamc | Clinic/Center | 1513 Cleveland Avenue, Suite 300, East Point, GA 30344-6951 | 2014-12-23 |
| 1669860888 | Atlanta Vamc | Clinic/Center | 2296 Henderson Mill Rd Ne Ste 402, Atlanta, GA 30345-2739 | 2014-12-23 |
| 1770836884 | Dublin Vamc | Clinic/Center | 1824 Ridge Avenue North, Tifton, GA 31794-9998 | 2012-10-26 |
| 1669729570 | Atlanta Vamc | Clinic/Center | 180 Martin Dr., Carrollton, GA 30117-2425 | 2012-08-09 |
| 1780814368 | Atlanta Vamc | Clinic/Center | 39-a Oak Hill Court, Newnan, GA 30265 | 2009-07-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ATLANTA VA MEDICAL CENTER.
| 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.