CHILDREN'S HEALTHCARE OF ATLANTA AT EGLESTON (NPI# 1649342502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649342502 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HEALTHCARE OF ATLANTA AT EGLESTON |
| Practice Address |
1405 Clifton Rd Ne Atlanta GA 30322-1060 |
| Mailing Address |
1575 Northeast Expy Ne Brookhaven GA 30329-2401 |
| Practice Telephone | 4047856000 |
| Mailing Telephone | 4047857876 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | MR. HAYDEN MATHIESON (VICE PRESIDENT, MANAGED CARE) |
| Authorized Official Telephone | 4047850589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | 044-079 | GA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | WELLCARE PROVIDER ID | 325817 | 01 |
| GA | AMERIGROUP PROVIDER ID | 10054176 | 01 |
| GA | PEACH STATE PROVIDER ID | 000000943D | 01 |
| GA | 000000943D | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174695035 | Children's Healthcare of Atlanta At Egleston | Ambulance | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2006-11-15 |
| 1083786941 | Children's Healthcare of Atlanta At Egleston | Ambulance | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2006-11-15 |
| 1881766749 | Children's Healthcare of Atlanta At Egleston | Clinic/Center | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2006-11-15 |
| Street Address |
1405 CLIFTON RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-1060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167040 | Kiesha Fraser Doh | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2006-01-06 |
| 1316548654 | Alexa Shea | Audiologist | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-11-03 |
| 1669071866 | Tara Hynes | Nurse Practitioner | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-10-20 |
| 1255947628 | Lauren Nicole Halula | Registered Nurse | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-09-21 |
| 1003424151 | Meagan Green | Nurse Practitioner | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-07-15 |
| 1518587096 | Diane Bailey | Registered Nurse | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-04-24 |
| 1194345264 | Meghan Mchale | Registered Nurse | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-04-19 |
| 1194344788 | Marisa Winter | Registered Nurse | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-04-13 |
| 1073142410 | Kaley Laurence French | Student in an Organized Health Care Education/Training Program | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-04-07 |
| 1326677600 | Chari Lakey | Technician/Technologist | 1405 Clifton Rd Ne, Atlanta, GA 30322-3050 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538631437 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 1400 Tullie Rd Ne Ste 601, Atlanta, GA 30329-2309 | 2018-12-18 |
| 1598193831 | Graham Reaves | Rehabilitation Unit | 1901 Phoenix Blvd, Suite 120, Atlanta, GA 30349-5063 | 2013-10-24 |
| 1275875395 | Choa Orthotics and Prosthetics | Rehabilitation Unit | 6 Executive Park Dr Ne, Atlanta, GA 30329-2221 | 2013-03-27 |
| 1467771923 | Children's Healthcare of Atlanta | Rehabilitation Unit | 5455 Meridian Marks Rd Ne Ste 300, Atlanta, GA 30342-4722 | 2010-05-24 |
| 1730251695 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 5445 Meridian Marks Rd Ne, Suite 200, Atlanta, GA 30342-4763 | 2006-11-15 |
| 1295760296 | Wellstar Atlanta Medical Center, Inc | Rehabilitation Unit | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2006-07-11 |
| 1144280215 | Piedmont Hospital, Inc. | Rehabilitation Unit | 1968 Peachtree Rd Nw, Atlanta, GA 30309-1281 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316456825 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 605 Big Shanty Road, Nw, Ste 100, Kennesaw, GA 30144-3646 | 2017-09-27 |
| 1386177798 | Southeast Georgia Health Services, L.L.C. | Rehabilitation Unit | 2500 Satilla Pkwy, Waycross, GA 31503-8852 | 2017-04-04 |
| 1578996245 | Complete Healthcare Management LLC | Rehabilitation Unit | 1060 Deer Chase, Stone Mountain, GA 30088-2404 | 2013-08-16 |
| 1306197702 | Children's Healthcare of Atlanta | Rehabilitation Unit | 2270 Duluth Hwy, Duluth, GA 30097-4010 | 2012-09-25 |
| 1497035489 | Body Mechanics Rehabilitation Services, LLC | Rehabilitation Unit | 524 New River Way, Mcdonough, GA 30252-4153 | 2011-08-22 |
| 1598990376 | Phoebe Sumter Medical Center, Inc. | Rehabilitation Unit | 126 Hwy 280 W, Americus, GA 31719-8645 | 2009-05-21 |
| 1124295274 | Va Medical Center-downtown Division/augusta | Rehabilitation Unit | 3336 Thames Pl, Hephzibah, GA 30815-7176 | 2008-05-08 |
| 1942412754 | Calhoun Memorial Hospital | Rehabilitation Unit | 103 R E Jennings Ave, Arlington, GA 39813 | 2007-05-04 |
| 1134168016 | Northside Hospital, Inc. | Rehabilitation Unit | 3215 Mcclure Bridge Rd, Duluth, GA 30096-3223 | 2006-06-06 |
| 1437103496 | Hca Health Services of Georgia, Inc. | Rehabilitation Unit | 102 Frist Ct, Columbus, GA 31909-3578 | 2006-05-22 |
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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.