GEORGIA INTEGRATIVE MEDICINE (NPI# 1760700199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760700199 |
| Entity Type | Organization |
| Organization Name | GEORGIA INTEGRATIVE MEDICINE |
| Practice Address |
120 Milbrook Village Drive Suite E Tyrone GA 30290 |
| Practice Telephone | 6788141333 |
| Practice Fax Number | 7707744431 |
| Mailing Telephone | 6788141333 |
| Mailing Fax Number | 7707744431 |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2010-05-10 |
| Authorized Official Name | YOON HANG KIM (DIRECTOR) |
| Authorized Official Telephone | 6788141333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
058355 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
120 MILBROOK VILLAGE DRIVE SUITE E |
| City | TYRONE |
| State | GA |
| Zip Code | 30290 |
| 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 |
| 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 |
| 1407973936 | Genesys Family Practice, Inc. | Family Medicine | 120 Handley Rd, Suite 410, Tyrone, GA 30290 | 2007-03-22 |
| Find all providers in zip 30290 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715137 | Ernest E Smith | Preventive Medicine | 115 W Dearborn Cir, Decatur, GA 30030-4474 | 2020-03-17 |
| 1033749288 | Atlanta Clinical Research Centers LLC | Preventive Medicine | 5673 Peachtree Dunwoody Rd Ste 440a, Atlanta, GA 30342-1797 | 2020-01-16 |
| 1316433105 | Thomas Boggs Richards | Preventive Medicine | 2067 Amberwood Way Ne, Atlanta, GA 30345-3903 | 2018-07-05 |
| 1871016592 | Sonja Suzzete Hutchins | Preventive Medicine | 435 Joseph E Lowery Blvd Sw, Atlanta, GA 30310-1471 | 2017-07-25 |
| 1922453547 | Passport Health Holdings, LLC | Preventive Medicine | 2470 Windy Hill Rd Se Ste 107, Marietta, GA 30067-8614 | 2016-05-02 |
| 1275988891 | Passport Health Holdings LLC | Preventive Medicine | 315 W Ponce De Leon Ave Ste 585, Decatur, GA 30030-2400 | 2016-05-02 |
| 1619336286 | Antonio Neri | Preventive Medicine | 1600 Clifton Rd Ne # Mse-92, Atlanta, GA 30329-4018 | 2016-02-11 |
| 1134597057 | Zachary Taylor IIi | Preventive Medicine | 1710 Whitehouse Ct, Dalton, GA 30720-8523 | 2015-09-09 |
| 1730557729 | Populations and Interventions Team Company (pitc) | Preventive Medicine | 3182 Berthas Overlook, Douglasville, GA 30135-8458 | 2015-09-08 |
| 1609252626 | Anthony Robbins | Preventive Medicine | 2707 Whispering Pines Ct, Decatur, GA 30033-1453 | 2015-07-31 |
| 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.