MEDICAS MEDICAL CLINIC, LLC (NPI# 1598269250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598269250 |
| Entity Type | Organization |
| Organization Name | MEDICAS MEDICAL CLINIC, LLC |
| Practice Address |
5846 Stewart Pkwy Douglasville GA 30135-2374 |
| Mailing Address |
Po Box 1215 Douglasville GA 30133-1215 |
| Practice Telephone | 7706167758 |
| Practice Fax Number | 7704890822 |
| Mailing Telephone | 7706167758 |
| Mailing Fax Number | 7704890822 |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |
| Authorized Official Name | MISS SARAH PRESIDENT (OWNER) |
| Authorized Official Telephone | 7706167758 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN166739 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5846 STEWART PKWY |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30135-2374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043301 | Heart & Soul Wellness Solutions LLC | Social Worker | 4752 Pepper Tree Lane, Douglasville, GA 30135 | 2020-08-12 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| 1003479411 | The Sister Circle of Love and Empowerment LLC | Clinic/Center | 4706 Boyer Glen Dr., Douglasville, GA 30135 | 2019-04-22 |
| 1457825358 | Marcia Ann-marie Wilson | Nurse Practitioner | 4279 Caroline Court, Douglasville, GA 30135 | 2019-01-14 |
| 1225564917 | Danielle Doebereiner-brown | Nurse Practitioner | 3872 Ga-5, Douglasville, GA 30135 | 2017-05-02 |
| 1851832430 | Jennifer Williams | Physical Therapist | 4999 Presley Mill Rd, Douglasville, GA 30135 | 2017-03-15 |
| 1316484686 | Geneva Brent | Licensed Practical Nurse | 2109 Fairburn Road, Douglasville, GA 30135 | 2017-01-25 |
| 1659816288 | Stephanie Walthour | Marriage & Family Therapist | 3400 Chapel Hill Rd Ste 317, Douglasville, GA 30135 | 2017-01-05 |
| 1770932105 | Solutions 2 Wellness and Recovery,llc | Social Worker | 2256 Greenwood Meadows Lane, Douglasville, GA 30135 | 2016-06-07 |
| 1326408378 | Sr & L Transport Services, LLC | Non-emergency Medical Transport (VAN) | 4841 Black Bear Trail, Douglasville, GA 30135 | 2016-03-03 |
| Find all providers in zip 30135 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710298 | Karen F Frazier | Nurse Practitioner | 6610 Crest Wood Ln, Douglasville, GA 30135-9046 | 2020-11-04 |
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1184268682 | Rasheedat Adunni Ibrahim | Nurse Practitioner | 6712 Brookfield Way, Douglasville, GA 30134-1461 | 2019-10-29 |
| 1538717475 | Shantel Brown | Nurse Practitioner | 3347 Surveyor Ct, Douglasville, GA 30135-8102 | 2019-09-03 |
| 1457825358 | Marcia Ann-marie Wilson | Nurse Practitioner | 4279 Caroline Court, Douglasville, GA 30135 | 2019-01-14 |
| 1962986224 | Sherry-ann Francis-grant | Nurse Practitioner | 6510 Manor Creek Dr, Douglasville, GA 30135-3681 | 2018-09-21 |
| 1891278602 | Monique Danielle Jasper | Nurse Practitioner | 3090 Stone Oak Dr, Douglasville, GA 30135-1903 | 2018-09-09 |
| 1720560006 | Chinelo Emekwue | Nurse Practitioner | 2361 Salah Cir, Douglasville, GA 30135-8159 | 2018-09-03 |
| 1477083913 | Angela Long | Nurse Practitioner | 6126 Prestley Mill Rd Ste H, Douglasville, GA 30134-5624 | 2017-06-18 |
| 1225564917 | Danielle Doebereiner-brown | Nurse Practitioner | 3872 Ga-5, Douglasville, GA 30135 | 2017-05-02 |
| Find all providers in DOUGLASVILLE | ||||
| City | DOUGLASVILLE |
| Zip Code | 30135 |
Please comment or provide details below to improve the information on MEDICAS MEDICAL CLINIC, LLC.
| 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.