INFECTIOUS DISEASE GROUP OF ATLANTA, LLC (NPI# 1558430363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558430363 |
| Entity Type | Organization |
| Organization Name | INFECTIOUS DISEASE GROUP OF ATLANTA, LLC |
| Other Organization Name | ID GROUP OF ATLANTA, LLC |
| Practice Address |
735 Piedmont Ave Ne Atlanta GA 30308-1416 |
| Practice Telephone | 4045884680 |
| Practice Fax Number | 4045884692 |
| Mailing Telephone | 4045884680 |
| Mailing Fax Number | 4045884692 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2012-07-06 |
| Authorized Official Name | JOHN P OUDERKIRK (OWNER) |
| Authorized Official Telephone | 4045884680 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 055003616A | 05 | |
| CLIA IDENTIFICATION # | 11D1023598 | 01 |
| Other Name | Type Code |
|---|---|
| ID Group of Atlanta, LLC | Doing Business As Name - Organization |
| Street Address |
735 PIEDMONT AVE NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308-1416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260508 | John P Ouderkirk | Internal Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2005-07-29 |
| 1730705047 | Aids Healthcare Foundation | Internal Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2020-06-23 |
| 1316449895 | Aids Healthcare Foundation | Pharmacy | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2018-03-01 |
| 1356851406 | Alexis Denice Mitchell | Family Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2017-10-03 |
| 1356729164 | Aids Healthcare Foundation | Clinic/Center | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2015-05-13 |
| 1861753816 | Delma Dee Gomez-adisa | Nurse Practitioner | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2012-06-06 |
| 1457541963 | Hudson Medical Group Inc | Specialist | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2007-07-31 |
| 1518083617 | Patrice Y Marshall | Preventive Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2007-03-21 |
| 1538216338 | Zandraetta L Tims-cook | Internal Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308 | 2007-01-04 |
| 1417901653 | Sophie Alexandra Lukashok | Internal Medicine | 735 Piedmont Ave Ne, Atlanta, GA 30308-1416 | 2006-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| 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 |
|---|---|---|---|---|
| 1417571175 | Infusimed, LLC | Internal Medicine | 2193 Cascade Rd Sw, Atlanta, GA 30311-2862 | 2020-05-28 |
| 1528689841 | Elysium Health and Wellness | Internal Medicine | 5555 Peachtree Dunwoody Rd Ste 201, Atlanta, GA 30342-1711 | 2020-04-27 |
| 1285096115 | Kimberley Fox | Internal Medicine | 1600 Clifton Rd Ne, Ms A-04, Cdc, Atlanta, GA 30329 | 2016-03-21 |
| 1275991648 | Mary Patricia Joyce | Internal Medicine | 1600 Clifton Road, E-47, Centers for Disease Control and Prevention, Atlanta, GA 30329 | 2016-02-01 |
| 1275970253 | Bernard M Branson | Internal Medicine | 2175 Eldorado Dr Ne, Atlanta, GA 30345-3414 | 2013-05-30 |
| 1437491917 | John E Mcgowan Jr. | Internal Medicine | 2421 Oak Grove Valley Rd Ne, Atlanta, GA 30345-3885 | 2013-03-21 |
| 1336436799 | Larry James Anderson | Internal Medicine | 2076 Continental Dr Ne, Atlanta, GA 30345-3400 | 2011-07-06 |
| 1225355365 | Kiren Mitruka | Internal Medicine | 119 Terrace Dr, Atlanta, GA 30305 | 2010-04-29 |
| 1619205192 | Thomas R Frieden | Internal Medicine | 1600 Clifton Rd Ne # Ms 14, Atlanta, GA 30329-4018 | 2009-11-22 |
| 1164652277 | Louise S Tashjian | Internal Medicine | 115 Helmsley Dr Nw, Atlanta, GA 30327-4940 | 2009-07-23 |
| Find all providers in ATLANTA | ||||
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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.