MEMORIAL HEALTH PARTNERS FOUNDATION, INC. (NPI# 1760632780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760632780 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HEALTH PARTNERS FOUNDATION, INC. |
| Other Organization Name | PROFESSIONAL PARK ASSOCIATES |
| Practice Address |
611 E Villanow St La Fayette GA 30728-2618 |
| Mailing Address |
Po Box 116638 Atlanta GA 30368-6638 |
| Practice Telephone | 7066381606 |
| Practice Fax Number | 7066389987 |
| Mailing Telephone | 4234958659 |
| Mailing Fax Number | 4234954970 |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2011-11-21 |
| Authorized Official Name | MR. MAELOR G HUGHES (PRESIDENT) |
| Authorized Official Telephone | 4234956870 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Professional Park Associates | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144633397 | Memorial Health Partners Foundation, Inc. | Clinic/Center | 645 Paul Huff Pkwy Nw, Suite 105, Cleveland, TN 37312-3149 | 2014-06-05 |
| 1669861530 | Memorial Health Partners Foundation, Inc. | Non-Pharmacy Dispensing Site | 611 E Villanow St, La Fayette, GA 30728-2618 | 2015-01-15 |
| 1467602482 | Memorial Health Partners Foundation, Inc. | Family Medicine | 6401 Mountain View Rd, Suite 109, Ooltewah, TN 37363-6681 | 2008-09-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HEALTH PARTNERS FOUNDATION, INC | 5600 Brainerd Rd Ste 500, Chattanooga, TN 37411-5371 |
| Street Address |
611 E VILLANOW ST |
| City | LA FAYETTE |
| State | GA |
| Zip Code | 30728-2618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336132679 | Eric J Betts | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-08-23 |
| 1255976726 | Jessica Rose Nowlin | Nurse Practitioner | 611 E Villanow St, La Fayette, GA 30728-2618 | 2019-11-08 |
| 1780152421 | Aubry Lynn Knight | Nurse Practitioner | 611 E Villanow St, La Fayette, GA 30728-2618 | 2018-11-12 |
| 1861977381 | Diana Morrison | Nurse Practitioner | 611 E Villanow St, La Fayette, GA 30728-2618 | 2018-10-01 |
| 1568910461 | Emily Elswick | Physician Assistant | 611 E Villanow St, La Fayette, GA 30728-2618 | 2016-09-20 |
| 1669861530 | Memorial Health Partners Foundation, Inc. | Non-Pharmacy Dispensing Site | 611 E Villanow St, La Fayette, GA 30728-2618 | 2015-01-15 |
| 1376520874 | Richard C Smith | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-27 |
| 1275510851 | Teddy A Scoggins | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-27 |
| 1346225919 | Suzanne Storey | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700820198 | Ralph Edward Bowers II | Family Medicine | 204 N Duke St, La Fayette, GA 30728-2505 | 2006-06-15 |
| 1801861935 | Aloysius T Mangan | Family Medicine | 615 E Villanow St, La Fayette, GA 30728-2618 | 2006-02-22 |
| 1336132679 | Eric J Betts | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-08-23 |
| 1508058066 | Lafayette Family Practice | Family Medicine | 611 N Main St, La Fayette, GA 30728-2241 | 2007-08-17 |
| 1366485948 | George Paul Shaw Jr. | Family Medicine | 611 N Main St, La Fayette, GA 30728-2241 | 2006-06-13 |
| 1124074992 | Lafayette After Hours, LLC | Family Medicine | 615 E Villanow St, La Fayette, GA 30728-2618 | 2006-05-25 |
| 1841266673 | David P Hall | Family Medicine | 615 E Villanow St, La Fayette, GA 30728-2618 | 2006-02-23 |
| 1376520874 | Richard C Smith | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-27 |
| 1275510851 | Teddy A Scoggins | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-27 |
| 1346225919 | Suzanne Storey | Family Medicine | 611 E Villanow St, La Fayette, GA 30728-2618 | 2005-12-07 |
| Find all providers in LA FAYETTE | ||||
| City | LA FAYETTE |
| Zip Code | 30728 |
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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.