MILL CREEK CLINIC, LLC (NPI# 1700278199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700278199 |
| Entity Type | Organization |
| Organization Name | MILL CREEK CLINIC, LLC |
| Practice Address |
7824 Hickory Flat Hwy Ste 120 Woodstock GA 30188-6575 |
| Mailing Address |
6175 Hickory Flat Hwy Ste 110-343 Canton GA 30115-7207 |
| Practice Telephone | 7706041930 |
| Practice Fax Number | 7706041929 |
| Mailing Telephone | 7707044911 |
| Mailing Fax Number | 7707044922 |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | DR. SHERYL BAILEY VICKERY (OWNER) |
| Authorized Official Telephone | 7703780328 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
26446 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 883092643D | 05 |
| Street Address |
7824 HICKORY FLAT HWY STE 120 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-6575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760935118 | Hale Healthcare, LLC | Clinic/Center | 120 N Medical Pkwy, Building 100, Suite 201, Woodstock, GA 30189-7062 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809108 | Lexington Primary Care LLC | Clinic/Center | 777 Athens Rd, Lexington, GA 30648-1902 | 2020-10-20 |
| 1619575834 | The Iv Spot, LLC. | Clinic/Center | 2100 Parklake Dr Ne # C-5, Atlanta, GA 30345-2824 | 2020-10-09 |
| 1528673514 | Safe Haven Medical Services | Clinic/Center | 444 Racetrack Rd, Mcdonough, GA 30252-6837 | 2020-09-15 |
| 1780296533 | North Atlanta Mental Wellness | Clinic/Center | 1742 Mount Vernon Rd Ste 150b, Atlanta, GA 30338-4251 | 2020-08-21 |
| 1639788136 | Walker Health and Wellness LLC | Clinic/Center | 111 Bradford Dr, Bloomingdale, GA 31302-4926 | 2020-07-30 |
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1598389637 | Mercie Health | Clinic/Center | 3721 New Macland Rd Ste 246, Powder Springs, GA 30127-2000 | 2020-06-04 |
| 1366061699 | Beyondmed LLC | Clinic/Center | 1820 Willow Branch Ln Nw, Kennesaw, GA 30152-4558 | 2020-04-16 |
| 1366082596 | Rock Health Inc | Clinic/Center | 5385 Five Forks Trickum Rd Ste F, Stone Mountain, GA 30087-3018 | 2020-01-15 |
| 1477192219 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 5163 Thompson Bridge Rd, Murrayville, GA 30564-1930 | 2019-12-26 |
| 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.