EASTSIDE MEDICAL CENTER, LLC (NPI# 1376597328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376597328 |
| Entity Type | Organization |
| Organization Name | EASTSIDE MEDICAL CENTER, LLC |
| Other Organization Name | EASTSIDE MEDICAL CENTER |
| Practice Address |
2160 Fountain Dr Snellville GA 30078-7022 |
| Mailing Address |
1700 Medical Way Snellville GA 30078-2195 |
| Practice Telephone | 7709853885 |
| Practice Fax Number | 7709853890 |
| Mailing Telephone | 7709790200 |
| Mailing Fax Number | 7707362395 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | AMY N. WHEELER (CFO) |
| Authorized Official Telephone | 7707362420 |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTSIDE MEDICAL CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| EASTSIDE MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649224692 | Eastside Medical Center, LLC | General Acute Care Hospital | 1700 Medical Way, Snellville, GA 30078-2195 | 2006-05-22 |
| 1558315507 | Eastside Medical Center, LLC | General Acute Care Hospital | 1700 Medical Way, Snellville, GA 30078-2195 | 2006-05-22 |
| 1467406413 | Eastside Medical Center, LLC | Psychiatric Unit | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2006-05-22 |
| 1467406132 | Eastside Medical Center, LLC | General Acute Care Hospital | 1700 Medical Way, Snellville, GA 30078-2195 | 2006-05-19 |
| Street Address |
2160 FOUNTAIN DR |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078-7022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280551 | Jae H Pak | Psychiatry & Neurology | 2160 Fountain Dr, Suite 200, Snellville, GA 30078-7022 | 2005-07-22 |
| 1326687930 | Joshua Morris | General Acute Care Hospital | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2019-12-30 |
| 1457839219 | Melissa Marie Gray | Nurse Practitioner | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2018-08-03 |
| 1114308475 | Kimberly Schiavoni | Nurse Practitioner | 2160 Fountain Dr, Suite D, Snellville, GA 30078-7022 | 2015-06-12 |
| 1578981130 | Eastside Behavioral Health Associates LLC | Psychiatry & Neurology | 2160 Fountain Dr, Suite 100, Snellville, GA 30078-7022 | 2014-04-01 |
| 1417192360 | Joshua Morris | Psychiatry & Neurology | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2008-12-06 |
| 1235388935 | Robin Matney Boggess | Nurse Practitioner | 2160 Fountain Dr, Suite D, Snellville, GA 30078-7022 | 2008-09-17 |
| 1407069685 | Georgia Psychological Services for Seniors Inc | Clinical Neuropsychologist | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2007-05-07 |
| 1396878500 | Franckel Val Md PC | Psychiatry & Neurology | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2007-03-14 |
| 1134290497 | Frankel Val Md PC | Legal Medicine | 2160 Fountain Dr, Snellville, GA 30078-7022 | 2006-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538631437 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 1400 Tullie Rd Ne Ste 601, Atlanta, GA 30329-2309 | 2018-12-18 |
| 1316456825 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 605 Big Shanty Road, Nw, Ste 100, Kennesaw, GA 30144-3646 | 2017-09-27 |
| 1386177798 | Southeast Georgia Health Services, L.L.C. | Rehabilitation Unit | 2500 Satilla Pkwy, Waycross, GA 31503-8852 | 2017-04-04 |
| 1578996245 | Complete Healthcare Management LLC | Rehabilitation Unit | 1060 Deer Chase, Stone Mountain, GA 30088-2404 | 2013-08-16 |
| 1306197702 | Children's Healthcare of Atlanta | Rehabilitation Unit | 2270 Duluth Hwy, Duluth, GA 30097-4010 | 2012-09-25 |
| 1497035489 | Body Mechanics Rehabilitation Services, LLC | Rehabilitation Unit | 524 New River Way, Mcdonough, GA 30252-4153 | 2011-08-22 |
| 1598990376 | Phoebe Sumter Medical Center, Inc. | Rehabilitation Unit | 126 Hwy 280 W, Americus, GA 31719-8645 | 2009-05-21 |
| 1124295274 | Va Medical Center-downtown Division/augusta | Rehabilitation Unit | 3336 Thames Pl, Hephzibah, GA 30815-7176 | 2008-05-08 |
| 1942412754 | Calhoun Memorial Hospital | Rehabilitation Unit | 103 R E Jennings Ave, Arlington, GA 39813 | 2007-05-04 |
| 1134168016 | Northside Hospital, Inc. | Rehabilitation Unit | 3215 Mcclure Bridge Rd, Duluth, GA 30096-3223 | 2006-06-06 |
| Find all providers with the same taxonomy | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
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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.