LOCUST GROVE FAMILY MEDICINE (NPI# 1629169164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629169164 |
Entity Type | Organization |
Organization Name | LOCUST GROVE FAMILY MEDICINE |
Practice Address |
3778 Highway 42 Locust Grove GA 30248-3632 |
Practice Telephone | 6786106649 |
Practice Fax Number | 6786106025 |
Mailing Telephone | 6786106649 |
Mailing Fax Number | 6786106025 |
Enumeration Date | 2006-09-28 |
Last Update Date | 2016-03-14 |
Authorized Official Name | DR. NIMISHA J TRIVEDI (OWNER) |
Authorized Official Telephone | 6786106649 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | 053715 | GA | Allopathic & Osteopathic Physicians |
Y | 332900000X | Non-Pharmacy Dispensing Site | 053715 | GA | Suppliers |
Street Address |
3778 HIGHWAY 42 |
City | LOCUST GROVE |
State | GA |
Zip Code | 30248-3632 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629074299 | Nimisha J Trivedi | Family Medicine | 3778 Highway 42, Locust Grove, GA 30248 | 2005-06-28 |
1871763011 | Chetan Sharma | Family Medicine | 3778 Highway 42, Locust Grove, GA 30248-3632 | 2008-03-04 |
1346333986 | Caridad M Monteilh | Nurse Practitioner | 3778 Highway 42, Locust Grove, GA 30248-3632 | 2006-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346809779 | Uyen Nguyen | Dentist | 4146 Ga-42, Locust Grove, GA 30248 | 2019-06-10 |
1669038303 | Monique Antoinette Joseph | Nurse Practitioner | 3334 Highway 155 Ste B, Locust Grove, GA 30248 | 2019-05-17 |
1811552524 | Fresenius Medical Care Locust Grove, LLC | Clinic/Center | 2855 Ga-155 S, Locust Grove, GA 30248 | 2019-05-08 |
1972167765 | Wesley Todd Livingston | Pharmacist | 2730 Ga 155, Locust Grove, GA 30248 | 2019-04-26 |
1053974550 | Wish You Well Youth Faith Foundation Inc | Contractor | 147 Laughlin Dr, Locust Grove, GA 30248 | 2019-04-19 |
1740776517 | Takle Eye Surgery Center LLC | Clinic/Center | 1075 Bandy Pkwy, Ste 105, Locust Grove, GA 30248 | 2018-07-05 |
1508357559 | Justin Robert Crumpton | Behavioral Analyst | 212 Westin Park Dr, Locust Grove, GA 30248 | 2018-05-25 |
1730679051 | Lisa Renee Jones | Family Medicine | 3778 G 42, Locus Grove, GA 30248 | 2018-05-11 |
1275042152 | Stephanie Jones Headen | Counselor | 211 Peeksville Rd., Locust Grove, GA 30248 | 2017-09-23 |
1942735592 | Brandi Nicole Buice Minter | Pharmacist | 4920 Bill Gardner Parkway, Locust Grove, GA 30248 | 2017-04-20 |
Find all providers in zip 30248 |
Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740823202 | Gwinnett Pulmonary Group Duluth | Non-Pharmacy Dispensing Site | 3855 Pleasant Hill Rd Ste 180, Duluth, GA 30096-8093 | 2019-10-28 |
1063061315 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 1280 Dogwood Dr Se, Conyers, GA 30013-5046 | 2019-09-10 |
1659929339 | Ankle and Foot Centers of Georgia, LLC | Non-Pharmacy Dispensing Site | 1975 Highway 54 W Ste 200, Peachtree City, GA 30269-4794 | 2019-08-27 |
1801444591 | Ankle and Foot Centers of Georgia, LLC | Non-Pharmacy Dispensing Site | 2326 Highway 34 E Ste 200, Newnan, GA 30265-1328 | 2019-08-27 |
1225686991 | Ankle and Foot Centers of Georgia, LLC | Non-Pharmacy Dispensing Site | 1819 Peachtree Rd Ne Ste 103, Atlanta, GA 30309-1848 | 2019-08-27 |
1265995724 | Georgia Urology Pa | Non-Pharmacy Dispensing Site | 5900 Hillandale Dr Ste 200, Lithonia, GA 30058-3858 | 2019-04-11 |
1861980955 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 4763 Atlanta Hwy Ste 420, Loganville, GA 30052-6788 | 2018-04-25 |
1184111338 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 10945 State Bridge Rd Ste 901, Alpharetta, GA 30022-8164 | 2018-04-13 |
1538666854 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 1575 Mount Vernon Rd, Dunwoody, GA 30338-4146 | 2018-04-12 |
1811494156 | Wellstreet of Georgia PC | Non-Pharmacy Dispensing Site | 6063 Peachtree Pkwy Ste 210a, Peachtree Corners, GA 30092-3303 | 2018-04-12 |
Find all providers with the same taxonomy |
City | LOCUST GROVE |
Zip Code | 30248 |
Please comment or provide details below to improve the information on LOCUST GROVE FAMILY MEDICINE.
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.