DR. AFUA SARPON BOATEN (NPI# 1972597656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972597656 |
| Entity Type | Individual |
| Full Name | DR. AFUA SARPON BOATEN |
| Credential | MD |
| Practice Address |
1046 Ridge Ave Sw Southside Medical Center Atlanta GA 30315-1640 |
| Practice Telephone | 4046881350 |
| Practice Fax Number | 4048013959 |
| Mailing Telephone | 4046881350 |
| Mailing Fax Number | 4048013959 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2015-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 54207 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 47166 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE PTAN | 202I080456 | 01 |
| GA | 403610618A,B | 05 | |
| GA | 403610618 | 05 |
| Street Address |
1046 RIDGE AVE SW SOUTHSIDE MEDICAL CENTER |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-1640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235123993 | Southside Medical Center, Inc. | Clinic/Center | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2005-09-08 |
| 1902427669 | Jacqueline Hamilton | Dietitian, Registered | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2020-05-04 |
| 1588290670 | Rutubula Pettaway | Social Worker | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2020-03-20 |
| 1063975944 | Donnamarie Wilson | Registered Nurse | 1046 Ridge Ave Sw, Atlanta, GA 30315 | 2019-04-09 |
| 1225598030 | Joi Raines | Nurse Practitioner | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2019-03-20 |
| 1417432006 | Taylor Breann Gonzalez | Advanced Practice Midwife | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-09-28 |
| 1154810299 | Keli Chapman | Midwife | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-05-03 |
| 1730680992 | Dena Boykin | Dental Hygienist | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-02-23 |
| 1063913234 | Sadaf Rehmani | Dental Hygienist | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-02-23 |
| 1629519251 | Anita Khimani | Clinic/Center | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2017-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
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| 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 |
|---|---|---|---|---|
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1912521782 | Eagles Landing Family Practice, LLC | Family Medicine | 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339-3304 | 2020-06-08 |
| 1487297164 | Deavmed L.l.c | Family Medicine | 3915 Cascade Rd Sw Ste T-90, Atlanta, GA 30331-8660 | 2019-10-24 |
| 1598319287 | Vibrant Family Medicine, P.C. | Family Medicine | 6667 Vernon Woods Dr Ste A19, Atlanta, GA 30328-3215 | 2019-07-30 |
| 1649739020 | Accumedic Diagnostic Management LLC | Family Medicine | 373 W Lake Ave Nw, Atlanta, GA 30318-8123 | 2019-03-15 |
| 1679037758 | Harrigan Medical Consulting Services, Inc | Family Medicine | 3280 Howell Mill Rd Nw Ste 207, Atlanta, GA 30327-4100 | 2019-01-23 |
| 1184197337 | Todd Ware Davis | Family Medicine | 942 Fern Ave Se, Atlanta, GA 30315-1813 | 2019-01-09 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1265902092 | Gregory Stephen Wallace | Family Medicine | 1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802 | 2018-12-05 |
| 1124596069 | Longevity Medical Center, PC | Family Medicine | 4646 N Shallowford Rd Ste 300, Atlanta, GA 30338-6308 | 2018-11-08 |
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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.