KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC (NPI# 1508123811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508123811 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC |
| Other Organization Name | KAISER PERMANENTE GWINNETT CLINIC PHARMACY |
| Practice Address |
3650 Steve Reynolds Blvd Duluth GA 30096-4506 |
| Practice Telephone | 7709316188 |
| Practice Fax Number | 7709316375 |
| Mailing Telephone | 7709316188 |
| Mailing Fax Number | 7709316375 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-12-05 |
| Authorized Official Name | DIANE SANDERS (PHARMACY COMPLIANCE MANAGER) |
| Authorized Official Telephone | 4049495336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PHCL000015 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1162255 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Gwinnett Clinic Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427325067 | Kaiser Foundation Health Plan of Georgia Inc | Pharmacy | 2142 W Broad St Bldg 200, Athens, GA 30606-3509 | 2011-11-28 |
| 1417214925 | Kaiser Foundation Health Plan of Georgia Inc | Pharmacy | 750 Townpark Ln Nw, Kennesaw, GA 30144-5579 | 2012-04-20 |
| 1265707244 | Kaiser Foundation Health Plan of Georgia Inc | Pharmacy | 750 Townpark Ln Nw, Kennesaw, GA 30144-5579 | 2012-03-09 |
| Street Address |
3650 STEVE REYNOLDS BLVD |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-4506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194893 | Barbara Joan Kell | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2005-06-16 |
| 1750906715 | Grace Elizabeth Mason | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2020-06-15 |
| 1881181584 | Cynthia Denise Humenic | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2018-04-18 |
| 1194230540 | Jenna Dannenbaum | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-12-07 |
| 1568994135 | Yolanda Gray-rozier | Registered Nurse | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-04-01 |
| 1306394655 | Carlie Lynne Adams | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-09-15 |
| 1114379757 | Miriam Abouelnasr Gomes | Physician Assistant | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-07-07 |
| 1699158584 | Ann Whitaker | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-09 |
| 1548643968 | Paula Gilman | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-02 |
| 1750763173 | Emily Kim | Internal Medicine | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902012107 | Metro Treatment of Minnesota, Lp | Pharmacy | 14 E Central Entrance, Suite B, Duluth, MN 55811-5508 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124598362 | Grady Memorial Hospital Corporation | Pharmacy | 80 Jesse Hill Jr Dr Se Rm 10b-043, Atlanta, GA 30303-3031 | 2018-11-30 |
| 1265974455 | Counseling Solutions of Chatsworth, LLC | Pharmacy | 1289 Gi Maddox Pkwy, Chatsworth, GA 30705-2069 | 2016-11-05 |
| 1912367111 | Carrollton Orthopaedic Clinic PC | Pharmacy | 812 S Park St Ste 3, Carrollton, GA 30117-4412 | 2016-03-01 |
| 1013376490 | Carrollton Orthopaedic Clinic PC | Pharmacy | 204 Allen Memorial Dr Ste 102, Bremen, GA 30110-2063 | 2016-02-15 |
| 1861791246 | New Start Treatment, LLC | Pharmacy | 1615 Highway 19 N, User, Thomaston, GA 30286-2277 | 2011-03-24 |
| 1740584770 | Southcoast Medical Group P C | Pharmacy | 1326 Eisenhower Dr Bldg 1, Savannah, GA 31406-3928 | 2011-01-05 |
| 1235348020 | Medicine Center of Atlanta | Pharmacy | 3646 Chamblee Tucker Rd, Suite C, Chamblee, GA 30341-4406 | 2007-05-21 |
| 1700099454 | Curtis V. Cooper Primary Health Care, Inc. | Pharmacy | 106 E. Broad St., Savannah, GA 31401-2917 | 2007-05-08 |
| 1720187602 | Forest Heights Phcy Inc | Pharmacy | Hlth Svcs Bldg, Watson Hall, Statesboro, GA 30460-0001 | 2006-09-21 |
| 1811902448 | Middle Flint Community Board | Pharmacy | 1335 N 5th Street Ext, Cordele, GA 31015-3753 | 2006-07-30 |
| Find all providers with the same taxonomy | ||||
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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.