PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC (NPI# 1316389836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316389836 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN CONSULTANTS OF GEORGIA INTERVENTIONAL LLC |
| Other Organization Name | MIDTOWN VASCULAR CENTER |
| Practice Address |
1445 Georgia Ave Suite 1 Macon GA 31201-7610 |
| Mailing Address |
Po Box 28854 Macon GA 31221-8854 |
| Practice Telephone | 4782501328 |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2014-02-13 |
| Authorized Official Name | DR. REUBEN KRIS ELLIS (PROPRIETOR) |
| Authorized Official Telephone | 4782501328 |
| Authorized Official Credential | M.D., FASN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
055819 | GA | Ambulatory Health Care Facilities |
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
055819 | GA | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
055819 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003124971A | 05 |
| Other Name | Type Code |
|---|---|
| MIDTOWN VASCULAR CENTER | Doing Business As Name - Organization |
| Street Address |
1445 GEORGIA AVE SUITE 1 |
| City | MACON |
| State | GA |
| Zip Code | 31201-7610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336185214 | Ahmed Yousef | Physical Medicine & Rehabilitation | 1445 Georgia Ave, Suite I, Macon, GA 31201-7610 | 2006-06-21 |
| 1962762708 | Physician Consultants of Georgia | Internal Medicine | 1445 Georgia Ave, Suite 3, Macon, GA 31201-7610 | 2012-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699110437 | Phillips Chiropractic, PC | Clinic/Center | 4045 Vineville Ave, Macon, GA 31210-5039 | 2013-05-07 |
| 1649417890 | Neurology of Central Georgia, LLC | Clinic/Center | 175 Water Tower Ct, Macon, GA 31210-4874 | 2009-01-09 |
| 1831352574 | Allergy & Asthma Center of Middle Georgia, Inc. | Clinic/Center | 3964 Elnora Dr, Macon, GA 31210-1825 | 2008-07-02 |
| 1841324639 | Atlantic Lung Center Inc | Clinic/Center | 560 1st St, Macon, GA 31201-2824 | 2007-03-15 |
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|---|---|---|---|---|
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| 1992331581 | World Spine and Orthopedics LLC | Clinic/Center | 4296 Memorial Dr Ste C, Decatur, GA 30032-1227 | 2020-03-16 |
| 1619517968 | Carroll Total Healthcare,pc | Clinic/Center | 410 Peachtree Pkwy Ste 4226, Cumming, GA 30041-7439 | 2020-01-14 |
| 1528601200 | Blued Consultant Solutions, LLC | Clinic/Center | 256 Rainbow Ln, Mcdonough, GA 30252-4839 | 2019-10-24 |
| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| Find all providers with the same taxonomy | ||||
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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.