EAGLES LANDING FAMILY PRACTICE, LLC (NPI# 1578827655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578827655 |
| Entity Type | Organization |
| Organization Name | EAGLES LANDING FAMILY PRACTICE, LLC |
| Practice Address |
1100 Hospital Dr Stockbridge GA 30281-6381 |
| Practice Telephone | 6784326161 |
| Practice Fax Number | 6784323677 |
| Mailing Telephone | 6784326161 |
| Mailing Fax Number | 6784323677 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | JEFF MITCHAM (COO) |
| Authorized Official Telephone | 7709140116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521782 | Eagles Landing Family Practice, LLC | Family Medicine | 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339-3304 | 2020-06-08 |
| 1144483744 | Eagles Landing Family Practice, LLC | Family Medicine | 1101 Nortec Dr Se, Conyers, GA 30013-5835 | 2008-07-03 |
| 1710079850 | Eagles Landing Family Practice, LLC | Family Medicine | 649 Jonesboro Road, Mcdonough, GA 30253 | 2006-09-28 |
| 1902907207 | Eagles Landing Family Practice, LLC | Family Medicine | 62 Kelly Rd, Mcdonough, GA 30253-6012 | 2006-09-26 |
| 1013018811 | Eagles Landing Family Practice, LLC | Family Medicine | 2330 Patrick Henry Pkwy, Suite 200, Mcdonough, GA 30253-4220 | 2006-09-26 |
| 1649623380 | Eagles Landing Family Practice, LLC | Family Medicine | 1240 Eagles Landing Pkwy, Suite 110, Stockbridge, GA 30281-5170 | 2016-07-18 |
| 1154774883 | Eagles Landing Family Practice, LLC | Internal Medicine | 145 Eagles Walk, Stockbridge, GA 30281-7340 | 2016-07-18 |
| 1073829073 | Eagles Landing Family Practice, LLC | Family Medicine | 2200 Highway 155 N, Mcdonough, GA 30252-4806 | 2010-08-27 |
| 1770744450 | Eagles Landing Family Practice, LLC | Family Medicine | 65 Old Jackson Rd, Mcdonough, GA 30252-3095 | 2008-06-24 |
| 1205919263 | Eagles Landing Family Practice, LLC | Family Medicine | 1502 Highway 16 E, Jackson, GA 30233-5202 | 2006-10-23 |
| Street Address |
1100 HOSPITAL DR |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-6381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760644355 | David Ross Penn | Radiology | 1035 Southcrest Dr Ste 250, Stockbridge, GA 30281-6117 | 2008-06-26 |
| 1386869535 | David William Allison | Radiology | 7402 Davidson Cir W, Stockbridge, GA 30281 | 2007-04-14 |
| 1871544098 | Open Mri and Ct Specialists of Stockbridge | Radiology | 1522 Rock Quarry Rd, Stockbridge, GA 30281-7386 | 2006-05-12 |
| 1396726014 | Northwest Diagnostic Imaging, Inc | Radiology | 204 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2005-11-09 |
| 1497081202 | Open Mri of Georgia, Inc | Radiology | 1035 Southcrest Dr, Suite 120, Stockbridge, GA 30281-6118 | 2009-10-29 |
| 1851524938 | Open Mri of Georgia, Inc | Radiology | 204 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2009-08-24 |
| 1265484182 | Henry County Radiology Associates | Radiology | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2006-05-17 |
| 1174573901 | Steven V Manzi | Radiology | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650136 | Tbi Diagnostic Centers of Georgia | Radiology | 4294 Memorial Dr Ste D, Decatur, GA 30032-1226 | 2020-08-21 |
| 1912464702 | Vickie Consuella71 Bush | Radiology | 3701 Bermuda Run Dr, Valdosta, GA 31605-1059 | 2019-02-27 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1578061636 | Subspecialty Imaging, LLC | Radiology | 1495 Hickory Flat Hwy Ste 150, Canton, GA 30115-4229 | 2018-01-24 |
| 1205354693 | Zenith Radiology LLC | Radiology | 1059 Windermere Xing, Cumming, GA 30041-6104 | 2017-09-06 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| 1902346422 | Allegiance Imaging and Radiology LLC | Radiology | 900 Thornton Rd, Ste A, Lithia Springs, GA 30122-2641 | 2017-03-02 |
| 1518406743 | Flexogenix Georgia PC | Radiology | 4600 Roswell Rd Unit E210, Sandy Springs, GA 30342-3197 | 2017-02-21 |
| 1649727215 | Metro Imaging Cumming, LLC | Radiology | 4150 Deputy Bill Cantrell Memorial Road, Cumming, GA 30040 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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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.