MODERN INTERNAL MEDICINE URGENT CARE AND PRIMARY CARE INC (NPI# 1528612694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528612694 |
| Entity Type | Organization |
| Organization Name | MODERN INTERNAL MEDICINE URGENT CARE AND PRIMARY CARE INC |
| Practice Address |
2457 Martin Luther King Jr, Dr, Sw Suit A Atlanta GA 30311 |
| Mailing Address |
2363 Timberbrook Trce Marietta GA 30066 |
| Practice Telephone | 7048586851 |
| Mailing Telephone | 7048586851 |
| Enumeration Date | 2019-07-27 |
| Last Update Date | 2020-08-28 |
| Authorized Official Name | MRS. HANNAH QUARSHIE (NP) |
| Authorized Official Telephone | 7048586851 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2457 MARTIN LUTHER KING JR, DR, SW SUIT A |
| City | ATLANTA |
| State | GA |
| Zip Code | 30311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528515053 | Cherese Williams | Counselor | 2636 M L K Jr Dr Sw, Suite 22, Atlanta, GA 30311 | 2016-09-01 |
| 1558754168 | James Edwin Wagner | Licensed Practical Nurse | 377 Peyton Road S W, Atlanta, GA 30311 | 2015-03-07 |
| 1790180131 | Johnny L Johnson | Nutritionist | 3030 Cambelton Rd, Atlanta, GA 30311 | 2014-10-28 |
| 1770718330 | Clayton E. Bell Sr. | Chiropractor | 2905 Campbellton Road, Suite G, Atlanta, GA 30311 | 2009-05-26 |
| 1720243207 | Farida Zohouri | Counselor | 2536 Martin Luther King Jr. Dr. Sw, Atlanta, GA 30311 | 2008-07-23 |
| 1649348962 | Mona Elaine Reynolds | Chiropractor | 3079 Campbellton Road, Suite 205, Atlanta, GA 30311 | 2006-12-04 |
| 1245337211 | Loreen C Doyle-littles | Pediatrics | 1175 Cascade Pkwy, Pediatrics Health Care Team A, Atlanta, GA 30311 | 2006-09-20 |
| 1740383512 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2429 Martin Luther King Jr. Dr., Atlanta, GA 30311 | 2006-09-07 |
| 1407806359 | Booker T Poe | Pediatrics | 2600 Martin Luther King Jr Dr, Ste 202, Atlanta, GA 30311 | 2006-05-11 |
| 1174581656 | Wendy M Morrow | Pediatrics | 3088 Campbellton Rd, Atlanta, GA 30311 | 2006-05-03 |
| Find all providers in zip 30311 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
| 1780238048 | Rasa Abital Teytel | Nurse Practitioner | 6105 Peachtree Dunwoody Rd Ste 125, Atlanta, GA 30328-5909 | 2019-07-25 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1780184366 | Anne E Taylor | Nurse Practitioner | 550 Peachtree St Ne Ste 1700, Atlanta, GA 30308-2262 | 2018-02-20 |
| 1487169173 | Terri Marie Clack | Nurse Practitioner | 2550 Akers Mill Rd Se Apt C26, Atlanta, GA 30339-3211 | 2017-12-05 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1093068397 | Lauren Eichel Nourparvar | Nurse Practitioner | 2580 Oglethorpe Cir Ne, Atlanta, GA 30319-6602 | 2012-10-24 |
| 1346800257 | Regine G Vincent | Nurse Practitioner | 3750 Peachtree Rd Ne, Atlanta, GA 30319-1385 | 2019-06-13 |
| 1629582135 | Mary Rabon Murfee | Nurse Practitioner | 3280 Howell Mill Rd Nw Ste 150, Atlanta, GA 30327 | 2017-11-20 |
| 1124555180 | Obianauju Okoroafor | Nurse Practitioner | 477 Windsor St Sw, Atlanta, GA 30312-2530 | 2017-05-20 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on MODERN INTERNAL MEDICINE URGENT CARE AND PRIMARY CARE INC.
| 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.