MED SOUTH ASSOCIATES PC 2 LLC (NPI# 1710017413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710017413 |
Entity Type | Organization |
Organization Name | MED SOUTH ASSOCIATES PC 2 LLC |
Practice Address |
6572 River Park Dr Suite 102 Riverdale GA 30274-2214 |
Mailing Address |
Po Box 468329 Atlanta GA 31146-8329 |
Practice Telephone | 4049430205 |
Mailing Telephone | 4049430205 |
Enumeration Date | 2007-03-06 |
Last Update Date | 2020-08-22 |
Authorized Official Name | ALICIA HOLDEN (LEAD) |
Authorized Official Telephone | 4049430205 |
Authorized Official Credential | ACCOUNTING |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
6572 RIVER PARK DR SUITE 102 |
City | RIVERDALE |
State | GA |
Zip Code | 30274-2214 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417921552 | Carlette Graham | Specialist | 6572 River Park Dr, Ste 101, Riverdale, GA 30274-2550 | 2006-02-15 |
1093180473 | Julia A Belcher | Licensed Practical Nurse | 6572 River Park Dr, Ste 101, Riverdale, GA 30274-2214 | 2015-12-10 |
1518024694 | Kaia Lowe | Physician Assistant | 6572 River Park Dr, #101, Riverdale, GA 30274-2214 | 2007-01-02 |
1457425480 | Andre' Reshaun Holmes | Specialist | 6572 River Park Dr, Riverdale, GA 30274-2214 | 2006-11-20 |
1770592776 | Sleepmed Inc. | Clinic/Center | 6572 River Park Dr, Suite 201, Riverdale, GA 30274-2214 | 2006-08-07 |
1720009244 | Pulmonary Medicine Associates | Specialist | 6572 River Park Dr, Ste 101, Riverdale, GA 30274-2214 | 2006-07-21 |
1265406375 | Praveen Rastogi | Internal Medicine | 6572 River Park Dr, Ste 101, Riverdale, GA 30274-2550 | 2006-02-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
Find all providers in zip 30274 |
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 |
---|---|---|---|---|
1861489163 | Yelena Pertsovsky | Internal Medicine | 5901 Palisade Ave, Riverdale, NY 10471-1205 | 2005-10-02 |
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.