M.E.M. MEDICAL SERVICES, P.C. (NPI# 1558664920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558664920 |
| Entity Type | Organization |
| Organization Name | M.E.M. MEDICAL SERVICES, P.C. |
| Practice Address |
200 Parkbrooke Dr Suite 100 Woodstock GA 30189-6331 |
| Mailing Address |
307 Gray Shingle Way Woodstock GA 30189-3775 |
| Practice Telephone | 7702189002 |
| Practice Fax Number | 6783845289 |
| Mailing Telephone | 7702189002 |
| Mailing Fax Number | 6783845289 |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |
| Authorized Official Name | MYRON MOOREHEAD (MANAGING MEMBER) |
| Authorized Official Telephone | 7702189002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 064985 | GA | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
064985 | GA | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
064985 | GA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
064985 | GA | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
064985 | GA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MANHATTAN EMERGENCY MEDICAL SERVICES, P.C. | 1365 York Avenue, New York, Ny 10021 |
| Massachusetts Corporations | MASSACHUSETTS EM-I MEDICAL SERVICES, P.C. | 6200 S. Syracuse Way, Suite 200, Greenwood Village, CO 80111 |
| New York State Corporations | MODERN METROPOLITAN MEDICAL SERVICES, P.C. | 116 Audley Street, Kew Gardens, Ny 11415 |
| Street Address |
200 PARKBROOKE DR SUITE 100 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-6331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013161637 | 360 Medical Management | Specialist | 200 Parkbrooke Dr, Suite 200, Woodstock, GA 30189-6331 | 2008-11-10 |
| 1619271442 | Serena Kumar | Nurse Practitioner | 200 Parkbrooke Dr, Suite 100, Woodstock, GA 30189-6331 | 2011-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720138696 | James David Ellner | Anesthesiology | 120 Stonebridge Pkwy, Suite 420, Woodstock, GA 30189-3767 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093331423 | Premier Healthcare Center Corp | Anesthesiology | 4153 Flat Shoals Pkwy Ste 102, Decatur, GA 30034-4106 | 2020-06-22 |
| 1205457710 | Urgent Pain Management, Inc | Anesthesiology | 1001 Virginia Ave, Hapeville, GA 30354-1328 | 2020-05-06 |
| 1831710854 | Md Pain Care, P.C. | Anesthesiology | 333 Alcovy St Ste 3, Monroe, GA 30655-2180 | 2020-04-30 |
| 1295356210 | Md Pain Care, P.C. | Anesthesiology | 5109 Highway 278 Ne Ste C, Covington, GA 30014-2608 | 2020-04-30 |
| 1407475296 | Georgia Injury & Pain Specialists | Anesthesiology | 7001 Hodgson Memorial Dr Ste 5, Savannah, GA 31406-2549 | 2020-04-11 |
| 1023645629 | Nexus Pain Center of Lagrange LLC | Anesthesiology | 1075 Lafayette Pkwy Ste 230, Lagrange, GA 30241-3734 | 2020-03-24 |
| 1255820502 | Georgia Pain and Spine Solutions, PC | Anesthesiology | 76 Highland Pavilion Court, #133, Hiram, GA 30141-3170 | 2018-05-02 |
| 1336527191 | Palmetto Pain Management of Ga, LLC | Anesthesiology | 5745 Clarion St, Cumming, GA 30040-0305 | 2015-05-13 |
| 1033546999 | Pain Management Specialists of Atlanta P C | Anesthesiology | 616a S 8th St, Suite A, Griffin, GA 30224-4214 | 2013-10-08 |
| 1649615584 | Nj Medical Services PC | Anesthesiology | 1016 Thompson Bridge Rd, Gainesville, GA 30501-1704 | 2013-05-06 |
| 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.