EASTSIDE MEDICAL CENTER, LLC (NPI# 1467406413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467406413 |
| 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 | 7709856473 |
| Practice Fax Number | 7707363063 |
| 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 | 273R00000X | Psychiatric 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 |
| 1376597328 | Eastside Medical Center, LLC | Rehabilitation 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922230648 | Peachstate Psychiatric Services, Inc. | Psychiatric Unit | 1720 Peachtree St Nw Ste 640, Atlanta, GA 30309-2450 | 2009-08-13 |
| 1982634572 | Gwinnett Hospital System, Inc. | Psychiatric Unit | 250 Scenic Hwy, Lawrenceville, GA 30045-5675 | 2006-07-03 |
| 1730123431 | John D. Archbold Memorial Hospital, Inc. | Psychiatric Unit | 401 Old Albany Rd, Thomasville, GA 31792-4014 | 2006-06-15 |
| 1023057775 | Floyd Healthcare Management Inc | Psychiatric Unit | 306 Shorter Ave Nw, Rome, GA 30165-4268 | 2006-06-06 |
| 1760436810 | Coliseum Medical Center, LLC | Psychiatric Unit | 340 Hospital Drive, Macon, GA 31217 | 2006-05-22 |
| 1902453111 | Sedzer Health LLC | Psychiatric Unit | 931 E Winthrope Ave, Millen, GA 30442-1839 | 2019-08-22 |
| 1578026431 | South Atlanta Psychiatry LLC | Psychiatric Unit | 253 Upper Riverdale Rd Sw Ste C, Riverdale, GA 30274-4945 | 2019-04-08 |
| 1518440254 | Prime Healthcare Foundation - Southern Regional, LLC | Psychiatric Unit | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-09-10 |
| 1831602903 | Savannah Health Services, LLC | Psychiatric Unit | 4700 Waters Ave, Savannah, GA 31404-6220 | 2017-11-13 |
| 1225559610 | Upson County Hospital Inc | Psychiatric Unit | 801 W Gordon St, Thomaston, GA 30286-3426 | 2017-07-06 |
| 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.