PEACHTREE IMMEDIATE CARE FP, LLC (NPI# 1982190039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982190039 |
| Entity Type | Organization |
| Organization Name | PEACHTREE IMMEDIATE CARE FP, LLC |
| Other Organization Name | PEACHTREE IMMEDIATE CARE |
| Practice Address |
3885 Mundy Mill Rd Ste 114 Oakwood GA 30566-3432 |
| Mailing Address |
1275 Highway 54 W Ste 201 Fayetteville GA 30214-4538 |
| Practice Telephone | 6789711892 |
| Practice Fax Number | 6789711895 |
| Mailing Telephone | 6786889685 |
| Mailing Fax Number | 7706263791 |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |
| Authorized Official Name | MRS. ANDREA MALIK-ROE (CFO) |
| Authorized Official Telephone | 6785046392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | INV-3-18-12009 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Peachtree Immediate Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649766791 | Peachtree Immediate Care Fp, LLC | Family Medicine | 3991 Highway 78 W Ste 100, Snellville, GA 30039-3929 | 2018-07-02 |
| 1023504180 | Peachtree Immediate Care Fp, LLC | Family Medicine | 1025 Veterans Memorial Hwy, Suite 720, Mableton, GA 30126-7239 | 2018-07-02 |
| 1538655683 | Peachtree Immediate Care Fp, LLC | Family Medicine | 371 Newnan Crossing Bypass, Suite 103, Newnan, GA 30265-1067 | 2018-07-02 |
| 1316433477 | Peachtree Immediate Care Fp, LLC | Family Medicine | 1495 Lafayette Pkwy, Lagrange, GA 30241-2552 | 2018-07-02 |
| 1437194156 | Peachtree Immediate Care Fp, LLC | Family Medicine | 3827 Jimmy Lee Smith Pkwy, Hiram, GA 30141-2630 | 2006-06-17 |
| Street Address |
3885 MUNDY MILL RD STE 114 |
| City | OAKWOOD |
| State | GA |
| Zip Code | 30566-3432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811480676 | Travis Core | Physical Therapist | 4220 Mundy Mill Pl Ste 2b, Oakwood, GA 30566 | 2018-06-07 |
| 1174922751 | Luke Lenahan | Physician Assistant | 3931 Mundy Mill Rd., Ste B, Oakwood, GA 30566 | 2014-08-19 |
| 1144584384 | Stephanie Mccullum | Occupational Therapist | 1006 Creeekside Place, Oakwood, GA 30566 | 2012-07-03 |
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1265673305 | Patti P Shipp | Counselor | 4347 Mundy Mill Rd Ste A2, Oakwood, GA 30566 | 2009-03-19 |
| 1124281217 | Ionut Radu | Optometrist | 3839 Mundy Mills Road, Oakwood, GA 30566 | 2008-07-08 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1851423057 | Oakwood Medical Clinic | Clinic/Center | 3626 Old Oakwood Rd, Oakwood, GA 30566 | 2007-03-12 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1003464538 | Nichole Abernathy Hasan | Pharmacist | Walmart Pharmacy, 3827 Mundy Mill Rd, Oakwood, GA 30566 | 2019-08-28 |
| Find all providers in zip 30566 | ||||
| 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 |
|---|---|---|---|---|
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1841447976 | Danny Cline | Family Medicine | 8243 Riverside Dr, Oakwood, VA 24631-8973 | 2008-08-20 |
| 1154414837 | Timothy Harvey Hogan | Family Medicine | 109 North First St., Oakwood, OH 45873 | 2006-10-02 |
| 1366534661 | Farhad M Yazdi | Family Medicine | 4205 Mundy Mill Pl, Suite 1, Oakwood, GA 30566-2566 | 2006-09-28 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1083694905 | Marti Renee Gibbs | Family Medicine | 4222 Fairbanks Dr, Oakwood, GA 30566-2811 | 2006-01-18 |
| 1982692125 | David Leonard Cohen | Family Medicine | 4323 Mundy Mill Rd Ste 101, Oakwood, GA 30566-2500 | 2005-10-12 |
| 1144218405 | Tawanna J Strauther | Family Medicine | 3931 Mundy Mill Rd, Suite A, Oakwood, GA 30566-3431 | 2005-10-11 |
| 1700226131 | Kelly Nicole O'dell | Family Medicine | 4222 Fairbanks Dr, Oakwood, GA 30566-2811 | 2013-06-29 |
| 1609114354 | Syah, LLC | Family Medicine | 4205 Mundy Mill Pl, Oakwood, GA 30566-2566 | 2013-01-30 |
| Find all providers in OAKWOOD | ||||
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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.