SUMMIT HEALTH PRIMARY AND URGENT CARE LLC (NPI# 1730729849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730729849 |
| Entity Type | Organization |
| Organization Name | SUMMIT HEALTH PRIMARY AND URGENT CARE LLC |
| Practice Address |
120 Handley Rd Bldg 400 Ste #410 Tyrone GA 30290-3029 |
| Mailing Address |
Po Box 935719 Atlanta GA 31193-5719 |
| Practice Telephone | 6784308478 |
| Mailing Telephone | 6784308478 |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | JARED DERANEY (OWNER) |
| Authorized Official Telephone | 4804820934 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
120 HANDLEY RD BLDG 400 STE #410 |
| City | TYRONE |
| State | GA |
| Zip Code | 30290-3029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407215361 | Kaitlin Lackey | Occupational Therapist | 105 Glendalough Court, Suite H, Tyrone, GA 30290 | 2016-02-19 |
| 1114211745 | Johannes Daniel Smit | Pharmacist | 525 Valleywood Drive, Tyrone, GA 30290 | 2011-05-31 |
| 1760700199 | Georgia Integrative Medicine | Preventive Medicine | 120 Milbrook Village Drive, Suite E, Tyrone, GA 30290 | 2010-05-10 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1386884138 | Genesys Ob/gyn, LLC | Clinic/Center | 245 Greencastle Road, Tyrone, GA 30290 | 2009-03-05 |
| 1689858805 | Immediate Care Centers of Georgia, LLC | Clinic/Center | 190 Greencastle Rd., Tyrone, GA 30290 | 2007-12-24 |
| 1437212834 | Dawn M Coffman | Physician Assistant | 190 Handley Rd., Tyrone, GA 30290 | 2006-12-18 |
| 1912971805 | Jason Rex Lee | Dentist | 195 Greencastle Rd, Tyrone, GA 30290 | 2006-02-15 |
| 1053898759 | Heather Renee Ellis | Physical Therapist | 62 Carriage Oaks Dr, Tyrone, GA 30290 | 2018-07-25 |
| 1134630858 | Marjorie Yvette Elibert | Advanced Practice Midwife | 190 Handley Rd Ste A, Tyrone, GA 30290 | 2017-10-20 |
| Find all providers in zip 30290 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 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.