NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC (NPI# 1912257957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912257957 |
| Entity Type | Organization |
| Organization Name | NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC |
| Other Organization Name | NSH CIPS A |
| Practice Address |
1498 Klondike Rd Sw Suite 106 Conyers GA 30094-5169 |
| Mailing Address |
1100 Johnson Ferry Rd Ne Center Pointe I, Suite 510 Atlanta GA 30342-1709 |
| Practice Telephone | 7707617260 |
| Mailing Telephone | 4044191159 |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-01-23 |
| Authorized Official Name | JORGE J HERNANDEZ (VP OF ADMIN SERVICES AND CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHSIDE HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| NSH CIPS A | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306197462 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 3400 Old Milton Pkwy # C, Suite 400, Alpharetta, GA 30005-3707 | 2012-09-28 |
| 1689925745 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 1505 Northside Blvd, Suite 4600, Cumming, GA 30041-7623 | 2012-09-28 |
| 1497006555 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 5670 Peachtree Dunwoody Rd Ne, Suite 1100, Atlanta, GA 30342-1699 | 2012-09-28 |
| 1215288378 | Nsh Cancer Institute Professional Services A LLC | Pharmacy | 5670 Peachtree Dunwoody Rd Ne, Suite 1100, Atlanta, GA 30342-1699 | 2012-09-28 |
| 1497006639 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 7813 Spivey Station Blvd, Suite 210, Jonesboro, GA 30236-2900 | 2012-09-27 |
| 1750631792 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 2545 Lawrenceville Hwy, Suite 100, Decatur, GA 30033-3239 | 2012-09-18 |
| Street Address |
1498 KLONDIKE RD SW SUITE 106 |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-5169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031974 | Donna-marie Erika Brown | Pediatrics | 1498 Klondike Rd Sw, Ste 106, Conyers, GA 30094-5169 | 2005-05-24 |
| 1174070981 | Tabitha Wishard Mcwhorter | Pharmacist | 1498 Klondike Rd Sw, Suite 106, Conyers, GA 30094-5169 | 2016-09-09 |
| 1336444546 | Meg Zeringue | Physician Assistant | 1498 Klondike Rd Sw, Suite 106, Conyers, GA 30094-5169 | 2011-01-19 |
| 1114161411 | Megan Jean Mckee | Internal Medicine | 1498 Klondike Rd Sw, Suite 106, Conyers, GA 30094-5169 | 2009-04-30 |
| 1083660104 | Richard Carter | Internal Medicine | 1498 Klondike Rd Sw, Suite 106, Conyers, GA 30094-5169 | 2006-05-26 |
| 1669475943 | Rotonda Keaton Williams | Physician Assistant | 1498 Klondike Rd Sw, Suite 106, Conyers, GA 30094-5169 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922622422 | Analia Home Health Care Services, LLC. | Durable Medical Equipment & Medical Supplies | 2365 Wall St Se Ste 230, Conyers, GA 30013-2197 | 2020-06-01 |
| 1659990810 | Sds Medical Supplies Inc. | Durable Medical Equipment & Medical Supplies | 2375 Wall St Se Ste 240 Rm 50, Conyers, GA 30013-6702 | 2020-04-08 |
| 1780174821 | King 1959, Inc. | Durable Medical Equipment & Medical Supplies | 2055 Gees Mill Rd Ne Ste 313, Conyers, GA 30013-1363 | 2018-05-15 |
| 1477839496 | Compression Ratios, Inc. | Durable Medical Equipment & Medical Supplies | 371 Gees Mill Business Pkwy, Suite 700, Conyers, GA 30013 | 2011-10-24 |
| 1205119294 | Omnimed Medical Supply and Equipment L.L.C. | Durable Medical Equipment & Medical Supplies | 3113 Edinburgh Ct, Conyers, GA 30094-6863 | 2011-09-26 |
| 1104113273 | Total Healthcare Products LLC | Durable Medical Equipment & Medical Supplies | 987 Okelly St Se, Suite C, Conyers, GA 30012-5462 | 2011-07-08 |
| 1831350214 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1783 Highway 138 Se, Conyers, GA 30013-1295 | 2008-06-19 |
| 1730389578 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 1301 Sigman Rd Ne Ste 160, Conyers, GA 30012-3913 | 2007-07-19 |
| 1255460341 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 2395 Wall Street, Suite 180, Conyers, GA 30013 | 2007-03-05 |
| 1073676995 | Secure Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 977 S Main St, #5e, Conyers, GA 30012 | 2006-12-19 |
| Find all providers in CONYERS | ||||
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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.