GENESIS ELDERCARE PHYSICIAN SERVICES LLC (NPI# 1699191452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699191452 |
| Entity Type | Organization |
| Organization Name | GENESIS ELDERCARE PHYSICIAN SERVICES LLC |
| Practice Address |
415 Airport Rd Griffin GA 30224-4834 |
| Mailing Address |
Po Box 42738 Towson MD 21284-2738 |
| Practice Telephone | 4105431957 |
| Mailing Telephone | 4104947607 |
| Mailing Fax Number | 6109257387 |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2018-04-12 |
| Authorized Official Name | ERIC SHAPIRO (VP, CONTROLLER) |
| Authorized Official Telephone | 4108327790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801215041 | Genesis Eldercare Physician Services LLC | Family Medicine | 835 Tenderfoot Hill Rd # T, Colorado Springs, CO 80906 | 2014-04-15 |
| 1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
| 1609180926 | Genesis Eldercare Physician Services LLC | Family Medicine | 6508 Deer Pointe Dr Ste A, Salisbury, MD 21804 | 2010-07-28 |
| 1326148107 | Genesis Eldercare Physician Services LLC | Skilled Nursing Facility | 14233 Alta Oaks Dr, Rockville, MD 20850-7413 | 2006-09-22 |
| 1699710202 | Genesis Eldercare Physician Services LLC | Internal Medicine | 11 Dairy Ln, Fredericksburg, VA 22405-2663 | 2006-06-18 |
| 1881635183 | Genesis Eldercare Physician Services LLC | Internal Medicine | 6508 Deer Pointe Dr, Suite A, Salisbury, MD 21804 | 2006-06-09 |
| 1104819259 | Genesis Eldercare Physician Services LLC | Internal Medicine | 464 Main St, Heritage Hall East, Agawam, MA 01001 | 2005-08-24 |
| 1164415196 | Genesis Eldercare Physician Services LLC | Internal Medicine | 1 Emerson Dr, Kimberly Hall North, Windsor, CT 06095 | 2005-08-24 |
| 1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
| 1548615313 | Genesis Eldercare Physician Services LLC | Internal Medicine | 7900 Constitution Ave Ne, Albuquerque, NM 87110 | 2016-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GENESIS ELDERCARE PHYSICIAN SERVICES LLC | 101 E State St, Kennett Sq, PA 19348-3109 |
| Street Address |
415 AIRPORT RD |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30224-4834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659321446 | Sunbridge Retirement Care Associates, LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2006-05-11 |
| 1063062412 | Airport Road Healthcare LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-18 |
| 1124678651 | Airport Road Realty LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-17 |
| 1144887720 | Pai Participant 11 PC | Internal Medicine | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-05-20 |
| 1396250890 | Dalton James Skipper | Nurse Practitioner | 415 Airport Rd, Griffin, GA 30224-4834 | 2017-12-06 |
| 1972039261 | Christie Thomas | Occupational Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2017-05-04 |
| 1730504515 | Deborah Husser | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-03-03 |
| 1427473735 | Yolanda Gwathmey | Physical Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-02-24 |
| 1003231317 | Launce Braddock | Occupational Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-02-24 |
| 1194972661 | Stacy Williams | Speech-Language Pathologist | 415 Airport Rd, Griffin, GA 30224-4834 | 2008-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346888971 | Latamika Renee Williams | Counselor | 1710 Ga-16 West, #6, Griffin, GA 30224 | 2019-12-13 |
| 1063062651 | Dominique S Paul-thompson | Contractor | 112 Deercreek Parkway, Griffin, GA 30224 | 2019-09-16 |
| 1497303531 | Xiaohui Zhang Brotzge | Physician Assistant | 601 S 8th Street, Griffin, GA 30224 | 2019-09-02 |
| 1548812282 | Andrew Dennis Nesmith | Registered Nurse | 601 South 8th St, Emergency Room, Griffin, GA 30224 | 2019-07-12 |
| 1073009122 | Alicia Skye Ledford | Nurse Practitioner | 619 S 8th St., Suite 200, Griffin, GA 30224 | 2018-07-02 |
| 1649787102 | Judith Fuajong Ngulefac | Nurse Practitioner | 1705 Williamson Rd, Griffin, GA 30224 | 2018-01-05 |
| 1699297077 | Amanda Norman | Speech-Language Pathologist | 106 Garnet Ln, Griffin, GA 30224 | 2017-07-07 |
| 1306214655 | Ruchi P Gandhi | Optometrist | 646 8th Street, Griffin, GA 30224 | 2015-09-03 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1437436094 | C. B. Reddy Md PC | Preferred Provider Organization | 610 S 8th Street, Suite F, Griffin, GA 30224 | 2011-11-10 |
| Find all providers in zip 30224 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144887720 | Pai Participant 11 PC | Internal Medicine | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710545553 | Palcare Health LLC | Internal Medicine | 1315 Merry Ln Ne, Atlanta, GA 30329-3903 | 2019-06-05 |
| 1518334200 | Miguel E Stubbs M D P C | Internal Medicine | 230 Beaver Falls Pl Sw, Atlanta, GA 30331-8326 | 2015-08-28 |
| 1497155469 | Golden Geriatrics LLC | Internal Medicine | 632 Vinings Estates Dr Se, Mableton, GA 30126-5991 | 2014-08-27 |
| 1821361577 | Senior Care Office, LLC | Internal Medicine | 2020 Beverly Road, Gainesville, GA 30501-2037 | 2012-02-10 |
| 1609162965 | Linduc PC | Internal Medicine | 2680 Lawrenceville Hwy Ste 202, Decatur, GA 30033-2526 | 2011-06-24 |
| 1447574918 | David L. Anders, M.d., P.C. | Internal Medicine | 101 Mcwilliams Dr, Peachtree City, GA 30269-6948 | 2010-03-26 |
| 1639319502 | New Snellville Clinic | Internal Medicine | 2331 Henry Clower Blvd, Suite A, Snellville, GA 30078-3155 | 2009-03-04 |
| 1952557977 | Diego Hernando Remolina | Internal Medicine | 49 Jesse Hill Jr Dr Se Rm 471, Atlanta, GA 30303 | 2008-08-11 |
| 1912165192 | Aristotle Cochon | Internal Medicine | 955 Lynn Dr, Waycross, GA 31503-8590 | 2008-05-25 |
| 1972792265 | Perimeter Medical Associates,p.c. | Internal Medicine | 3775 N. Druid Hills Rd, Decatur, GA 30033 | 2007-10-23 |
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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.