KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1699003681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699003681 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. |
| Other Organization Name | KAISER PERMANENTE DECATUR PHARMACY |
| Practice Address |
201 W Ponce De Leon Ave Decatur GA 30030-3217 |
| Practice Telephone | 4046877680 |
| Practice Fax Number | 4046877730 |
| Mailing Telephone | 4046877680 |
| Mailing Fax Number | 4046877730 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2011-06-15 |
| Authorized Official Name | DIANE SANDERS (PHARMACY COMPLIANCE MANAGER) |
| Authorized Official Telephone | 4049495336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
PHRE009629 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1159335 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Decatur Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811321763 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1100 Lake Hearn Dr Ste 500, Atlanta, GA 30342-1548 | 2013-08-28 |
| 1598061608 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 225 Peachtree St Ne Ste C-08, Atlanta, GA 30303-1701 | 2011-02-07 |
| 1174826754 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1478 Dogwood Dr Se, Conyers, GA 30013-5088 | 2010-12-21 |
| 1053612119 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2010-11-05 |
| 1063733210 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2505 Dallas Hwy Sw, Marietta, GA 30064-2659 | 2010-06-22 |
| 1538480553 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 2240 Fountain Dr, Snellville, GA 30078-2919 | 2010-06-14 |
| 1881910552 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 | 2010-04-20 |
| 1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
| 1447487574 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1400 Northside Forsyth Dr Ste 350, Cumming, GA 30041-6018 | 2009-06-16 |
| 1366622912 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 8011 Mall Pkwy, Lithonia, GA 30038-2543 | 2007-11-13 |
| Street Address |
201 W PONCE DE LEON AVE |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861746752 | Paula A Burgess | Emergency Medicine | 201 W Ponce De Leon Ave, #32, Decatur, GA 30030-3217 | 2012-10-31 |
| 1356635189 | James Reid Malone | Pharmacist | 201 W Ponce De Leon Ave, 431, Decatur, GA 30030-3217 | 2011-06-09 |
| 1871823328 | Kaiser Permanente | Clinical Medical Laboratory | 201 W Ponce De Leon Ave, Suite A, Decatur, GA 30030-3217 | 2010-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| 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 |
|---|---|---|---|---|
| 1316465859 | Integrated Health Solutions LLC | Pharmacy | 1284 Glandor Ct Se, Mableton, GA 30126-2755 | 2017-09-05 |
| 1174826754 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1478 Dogwood Dr Se, Conyers, GA 30013-5088 | 2010-12-21 |
| 1053612119 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 2010-11-05 |
| 1881910552 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 | 2010-04-20 |
| 1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
| 1366622912 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 8011 Mall Pkwy, Lithonia, GA 30038-2543 | 2007-11-13 |
| 1518090836 | Northeast Georgia Health Services | Pharmacy | 825 Jesse Jewell Parkway Suite D, Gainesville, GA 30501-3715 | 2007-03-14 |
| 1578606950 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 | 2007-02-15 |
| 1568577450 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 | 2006-08-20 |
| 1932141710 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 2006-06-13 |
| 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.