FOUR CORNERS PRIMARY CARE CENTERS, INC. (NPI# 1356682959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356682959 |
| Entity Type | Organization |
| Organization Name | FOUR CORNERS PRIMARY CARE CENTERS, INC. |
| Practice Address |
175 Gwinnett Dr Suite 213 Lawrenceville GA 30046-8444 |
| Mailing Address |
5030 Georgia Belle Ct Suite 2066 Norcross GA 30093-2667 |
| Practice Telephone | 7702793142 |
| Practice Fax Number | 7702345210 |
| Mailing Telephone | 7702793142 |
| Mailing Fax Number | 7702345210 |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-09-27 |
| Authorized Official Name | MS. SUSAN A JOHNSON (CFO) |
| Authorized Official Telephone | 7702793142 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235648817 | Four Corners Primary Care Centers, Inc. | Pharmacy | 5300 Oakbrook Pkwy Ste 130, Norcross, GA 30093-2261 | 2017-09-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FOUR CORNERS PRIMARY CARE CENTERS, INC. | 5300 Oakbrook Pkwy Ste 130, Norcross, GA 30093-2261 |
| Street Address |
175 GWINNETT DR SUITE 213 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609853860 | View Point Health | Day Training, Developmentally Disabled Services | 175 Gwinnett Dr, Post Office Box 687, Lawrenceville, GA 30046-8444 | 2005-12-29 |
| 1235739400 | Jennifer Kabiu | Registered Nurse | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-10-27 |
| 1164021135 | Irene Bautista Lopez | Counselor | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-10-21 |
| 1720686132 | Kimberly Gamble | Registered Nurse | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-10-16 |
| 1205443868 | Pablo David Faundez | Counselor | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-28 |
| 1295341717 | Sydney Calloway | Counselor | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-21 |
| 1275149932 | Kenysha Doyen Thompson | Social Worker | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-18 |
| 1457967218 | Taylor Mays | Social Worker | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-17 |
| 1366058299 | Emma Paduraru | Nutritionist | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-16 |
| 1922613330 | Shamikia Mcghee | Counselor | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-09-11 |
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|---|---|---|---|---|
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| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
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| City | LAWRENCEVILLE |
| Zip Code | 30046 |
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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.