MEDSOUTH ASSOCIATES PC (NPI# 1508057589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508057589 |
| Entity Type | Organization |
| Organization Name | MEDSOUTH ASSOCIATES PC |
| Practice Address |
483 Upper Riverdale Rd Sw Ste G Riverdale GA 30274-2584 |
| Practice Telephone | 7709969400 |
| Practice Fax Number | 7709912918 |
| Mailing Telephone | 7709969400 |
| Mailing Fax Number | 7709912918 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | RICHARD WRIGHT (OFFICE MANAGER) |
| Authorized Official Telephone | 7709969400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036647 | GA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 046927 | GA | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 022956 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000892581F | 05 | |
| GA | 000897949A | 05 | |
| BC | 855141 | 01 | |
| GA | 000252238A | 05 | |
| BC | 003004 | 01 | |
| BC | 149377 | 01 |
| Street Address |
483 UPPER RIVERDALE RD SW STE G |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-2584 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770573552 | Richard I Wright | Internal Medicine | 483 Upper Riverdale Rd Sw Ste G, Riverdale, GA 30274-2584 | 2005-10-24 |
| 1568085587 | Eighty Health and Wellness LLC | Clinic/Center | 483 Upper Riverdale Rd Sw Ste G, Riverdale, GA 30274-2579 | 2020-05-26 |
| 1124660659 | Yudelky Tereza Bentley | Nurse Practitioner | 483 Upper Riverdale Rd Sw Ste G, Riverdale, GA 30274-2584 | 2019-10-16 |
| 1053410357 | Paul L Harvey | Internal Medicine | 483 Upper Riverdale Rd Sw Ste G, Riverdale, GA 30274-2584 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1821418468 | Christopher Charles Richardson I | Internal Medicine | 3567 W Mount Whitney Ave, Riverdale, CA 93656 | 2014-04-22 |
| 1386922441 | Kathleen O'hara Johnson | Internal Medicine | 6330 Riverdale Rd, Riverdale, GA 30274-1617 | 2011-07-23 |
| 1104092048 | Victor Ezinna Okeh | Internal Medicine | 483 Upper Riverdale Rd Sw Ste F, Riverdale, GA 30274 | 2008-04-30 |
| 1619158730 | Alpesh Bhagubhai Patel | Internal Medicine | 11 Upper Riverdale Rd Sw Fl 6, Riverdale, GA 30274-2615 | 2007-11-16 |
| 1194913053 | South Metro Primary Care | Internal Medicine | 261 Medical Way, Suite A, Riverdale, GA 30274-2522 | 2007-10-04 |
| 1821126673 | Douglas Satcher | Internal Medicine | 261 Medical Way Ste A, Riverdale, GA 30274-2522 | 2007-03-02 |
| 1730235771 | Victoria Harris Thedford | Internal Medicine | 155 Medical Way Ste E, Riverdale, GA 30274 | 2007-01-25 |
| 1184782369 | Reva Gill | Internal Medicine | 6510 Kenilworth Avenue, Suite 2400, Riverdale, MD 20737 | 2006-12-04 |
| 1447329263 | Deepak Bhagwandas | Internal Medicine | 7529 Shannon Oak Dr, Riverdale, GA 30296-1445 | 2006-11-07 |
| Find all providers in RIVERDALE | ||||
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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.