MOUNTAINSIDE PEDIATRICS (NPI# 1710267505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710267505 |
| Entity Type | Organization |
| Organization Name | MOUNTAINSIDE PEDIATRICS |
| Practice Address |
12 Sammy Mcghee Blvd Suite 102 Jasper GA 30143-7711 |
| Mailing Address |
12 Sammy Mcghee Boulavard Suite 102 Jasper GA 30143-7711 |
| Practice Telephone | 7062539898 |
| Practice Fax Number | 7062539896 |
| Mailing Telephone | 7062539898 |
| Mailing Fax Number | 7062539896 |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |
| Authorized Official Name | DR. KHAWAJA RAZA MAHMOOD (SOLE PROPRIETOR) |
| Authorized Official Telephone | 7062539898 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
42648 | GA | Ambulatory Health Care Facilities |
| Street Address |
12 SAMMY MCGHEE BLVD SUITE 102 |
| City | JASPER |
| State | GA |
| Zip Code | 30143-7711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861486557 | Khawaja R Mahmood | Pediatrics | 12 Sammy Mcghee Blvd, Ste 102, Jasper, GA 30143-4093 | 2005-09-08 |
| 1497306096 | Kayleigh Pritchett | Nurse Practitioner | 12 Sammy Mcghee Blvd, Jasper, GA 30143-7711 | 2019-09-25 |
| 1942608799 | Jeanne Frances Anderson | Nurse Practitioner | 12 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143-7711 | 2014-12-10 |
| 1639454408 | Wellstar Cardiovascular Medicine, LLC | Internal Medicine | 12 Sammy Mcghee Blvd, Suite 202, Jasper, GA 30143-7711 | 2011-10-12 |
| 1912041989 | Mastercare Medical Center | Legal Medicine | 12 Sammy Mcghee Blvd, Ste. 101, Jasper, GA 30143-7711 | 2007-02-16 |
| 1588719470 | Moiz Vasim Master | Internal Medicine | 12 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143-7711 | 2007-01-24 |
| 1346301470 | Complete Health Diagnostics, Inc. | Technician, Other | 12 Sammy Mcghee Blvd, Suite 203, Jasper, GA 30143-7711 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871044677 | Med 360 Urgent Care, LLC | Clinic/Center | 1700 Highway 78 E, Jasper, AL 35501-4036 | 2016-10-18 |
| 1326645573 | Pickens Urgent Care LLC | Clinic/Center | 744 Noah Dr Ste 108-109, Jasper, GA 30143-8705 | 2020-10-01 |
| 1548872609 | Watson Healthcare LLC | Clinic/Center | 413 5th Ave Nw Ste A, Jasper, FL 32052-7801 | 2020-08-20 |
| 1467810929 | Rolando Newland | Clinic/Center | 1454 Jones Dairy Rd, Jasper, AL 35501-6164 | 2016-01-29 |
| 1427482074 | Evan B Hurst, Md, Internal Medicine, PC | Clinic/Center | 721 W 13th St, Suite 322, Jasper, IN 47546-1855 | 2013-08-29 |
| 1285973016 | Ann B Patterson Md PC | Clinic/Center | 721 W 13th St, Suite 322, Jasper, IN 47546-1855 | 2013-02-14 |
| 1801075957 | Jasper Diagnostic Clinic | Clinic/Center | 300 Marvin Hancock Dr, Jasper, TX 75951-3480 | 2007-10-25 |
| 1548483589 | Peter A Bidwell Family Practice | Clinic/Center | 1007 Dickerson Dr, Jasper, TX 75951-5110 | 2007-04-10 |
| 1225067051 | Daniel Kirk Mcdonald | Clinic/Center | 1800 Birmingham Ave, Jasper, AL 35501-5461 | 2006-07-02 |
| 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.