ST. MARY'S MEDICAL GROUP, INC. (NPI# 1336446608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336446608 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S MEDICAL GROUP, INC. |
| Other Organization Name | NORTHEAST CARDIOLOGY |
| Practice Address |
700 Sunset Dr Ste 302 Athens GA 30606-7721 |
| Mailing Address |
Po Box 48089 Athens GA 30604-8089 |
| Practice Telephone | 7065489111 |
| Practice Fax Number | 7065489224 |
| Mailing Telephone | 7063893740 |
| Mailing Fax Number | 7063893951 |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2018-03-30 |
| Authorized Official Name | D. MONTEZ CARTER (PRESIDENT & CEO) |
| Authorized Official Telephone | 7063893930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Northeast Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935411 | St. Mary's Medical Group, Inc. | Allergy & Immunology | 1360 Caduceus Way Bldg 200-102, Watkinsville, GA 30677-7349 | 2020-06-02 |
| 1437407053 | St. Mary's Medical Group, Inc. | Obstetrics & Gynecology | 355 Clear Creek Pkwy Ste 1004, Lavonia, GA 30553-4271 | 2012-08-29 |
| 1932672300 | St. Mary's Medical Group, Inc. | Internal Medicine | 1021 Jamestown Blvd Ste 215, Watkinsville, GA 30677-4176 | 2019-01-08 |
| 1083189591 | St. Mary's Medical Group, Inc. | Neurological Surgery | 2142 W Broad St Ste 200, Athens, GA 30606-3506 | 2018-10-11 |
| 1285116210 | St. Mary's Medical Group, Inc. | Family Medicine | 1181 Langford Dr Ste 103, Watkinsville, GA 30677 | 2018-09-06 |
| 1528516929 | St. Mary's Medical Group, Inc. | Surgery | 355 Clear Creek Pkwy, Suite 1008, Lavonia, GA 30553-4174 | 2016-09-14 |
| 1912454224 | St. Mary's Medical Group, Inc. | Internal Medicine | 2470 Daniels Bridge Rd Ste 271, Athens, GA 30606 | 2016-09-02 |
| 1497105597 | St. Mary's Medical Group, Inc. | Family Medicine | 12134 Augusta Rd, Suite A, Lavonia, GA 30553-1208 | 2016-06-20 |
| 1003264524 | St. Mary's Medical Group, Inc. | Internal Medicine | 1622 Mars Hill Rd Ste C, Watkinsville, GA 30677-4893 | 2016-05-25 |
| 1588047138 | St. Mary's Medical Group, Inc. | Pediatrics | 1020 Jamestown Blvd, Bldg 200, Watkinsville, GA 30677-4131 | 2015-07-01 |
| Street Address |
700 SUNSET DR STE 302 |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-7721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134286636 | Arthur Eugene Mays Jr. | Internal Medicine | Nuclear Plant Rd, Nuclear Training Bldng, Athens, AL 35611 | 2007-01-03 |
| 1568476166 | Moe H Bishara | Internal Medicine | 1351 Lake Welbrook Dr, Athens, GA 30606-7631 | 2006-07-28 |
| 1720054349 | Charles B Neckman | Internal Medicine | 2470 Daniels Brigde Road, Bldg 200 Suite 251, Athens, GA 30606 | 2006-02-23 |
| 1437131273 | Saima Zafar | Internal Medicine | 115 Medical Cir Ste 102, Athens, TX 75751-9004 | 2005-11-17 |
| 1811987670 | Michael C Tobes | Internal Medicine | 1212 S Palestine St, Athens, TX 75751-3619 | 2005-10-24 |
| 1366443640 | Subodh K Agrawal | Internal Medicine | 2005 Prince Ave, Athens, GA 30606-6032 | 2005-08-09 |
| 1942208970 | Harvey G Ouzts | Internal Medicine | 2470 Daniels Bridge Rd, Bldg 200, Ste 251, Athens, GA 30606-6187 | 2005-07-13 |
| 1164926739 | Athens Heart Center, PC | Internal Medicine | 1999 Prince Ave, Athens, GA 30606-6013 | 2018-03-20 |
| 1508378613 | Medical Office Force, LLC | Internal Medicine | 2005 Prince Avenue, Athens, GA 30606 | 2017-10-30 |
| 1902231327 | James Dowling | Internal Medicine | 2470 Daniels Bridge Rd Ste 251, Athens, GA 30606 | 2013-09-04 |
| Find all providers in ATHENS | ||||
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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.