Richard P Hollstrom Jr. (NPI# 1710939145, PAC ID# 6507839453) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1710939145 |
| PAC ID by PECOS | 6507839453 |
| Professional Enrollment ID | I20040823000327 |
| Full Name | Richard P Hollstrom Jr. |
| Organization Legal Name | MED VENTURES MRI, LLC |
| Address |
1075 Lafayette Pkwy Suite 120 Lagrange GA 30241-3584 |
| Phone Number | 7067566017 |
| Gender | M |
| Credential | DPM |
| Medical School | BARRY UNIVERSITY SCHOOL PODIATRIC MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 7810281573 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110016 | WEST GEORGIA MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 5335 Old National Hwy, Atlanta, GA 30349-3203 | 4047683668 | ANKLE AND FOOT CENTERS OF GEORGIA, LLC |
| 1075 Lafayette Pkwy, Suite 120, Lagrange, GA 30241-3584 | 7067566017 | MED VENTURES MRI, LLC |
| 1975 Hwy 54 W, Peachtree City, GA 30269-4794 | ANKLE AND FOOT CENTERS OF GEORGIA, LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_039_overall | Screening for Osteoporosis for Women Aged 65-85 Years of Age | 3% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 2% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 4% | |
| MIPS_EC_113_overall | Colorectal Cancer Screening | 8% | |
| MIPS_EC_117_overall | Diabetes: Eye Exam | 39% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 48% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 97% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 83% |
| Organization Legal Name | MED VENTURES MRI, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Greer | Neurology | Med Ventures Mri, LLC | 1075 Lafayette Pkwy, Suite 120, Lagrange, GA 30241-3584 |
| Street Address |
1075 LAFAYETTE PKWY SUITE 120 |
| City | LAGRANGE |
| State | GA |
| Zip | 30241-3584 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Anthony Martin | Podiatry | Ankle and Foot Centers of Georgia, LLC | 1075 Lafayette Pkwy, Suite 200, Lagrange, GA 30241-3584 |
| Davin Gerrard Mitchell | Anesthesiology | 1075 Lafayette Pkwy, Suite 100, Lagrange, GA 30241-3584 | |
| Tracy W Flory | Nurse Practitioner | Lafayette Neurology, PC | 1075 Lafayette Pkwy, Suite 210, Lagrange, GA 30241-3584 |
| Lowell Evan Michael | Pathology | Surgical and Cosmetic Dermatology, P. C. | 1075 Lafayette Pkwy, Suite 240, Lagrange, GA 30241-3584 |
| Takia M Oglesby | Pain Management | Lafayette Neurology, PC | 1075 Lafayette Pkwy, Suite 210, Lagrange, GA 30241-3584 |
| Robert Greer | Neurology | Med Ventures Mri, LLC | 1075 Lafayette Pkwy, Suite 120, Lagrange, GA 30241-3584 |
| Amy Purdy | Physical Therapy | Med Ventures Physical Therapy LLC | 1075 Lafayette Pkwy, Suite 220, Lagrange, GA 30241-3733 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chantel L Colmer | Chiropractic | Back To Life Chiropractic Center Inc | 1505 Lafayette Pkwy, Lagrange, GA 30241-2513 |
| Tammi L Kaminsky | Chiropractic | Back To Life Chiropractic Center Inc | 1505 Lafayette Pkwy, Lagrange, GA 30241-2513 |
| Sandeep Singh | Nurse Practitioner | Peachtree Immediate Care Fp, LLC | 1495 Lafayette Pkwy, Lagrange, GA 30241-2552 |
| Olumide Ajayi | Family Medicine | Wellstar Medical Group, LLC | 1497 Lafayette Pkwy, Lagrange, GA 30241-2552 |
| Cynthia M Bokor | Physician Assistant | Peachtree Immediate Care Fp, LLC | 1495 Lafayette Pkwy, Lagrange, GA 30241-2552 |
| Ferdinand Q Alcaide | Nephrology | Renal Associates of Lagrange LLC | 1300 Lafayette Pkwy E, Building D, Lagrange, GA 30241-2610 |
| Carrie Whitehead | Nurse Practitioner | Renal Associates of Lagrange LLC | 1300 Lafayette Pkwy E, Building D, Lagrange, GA 30241-2610 |
| John Andrews | Psychiatry | 321 Greenville St, Lagrange, GA 30241-3231 | |
| Eric A Crouch | Chiropractic | 413 Greenville St, Lagrange, GA 30241-3360 | |
| Syed A W Ahmed | Internal Medicine | 142 Old Mill Rd, Lagrange, GA 30241-6704 | |
| Find all physicians in zip 30241 | |||
| City | LAGRANGE |
| Zip Code | 30241 |
| Specialty | PODIATRY |
| City + Specialty | LAGRANGE + PODIATRY |
Please comment or provide details below to improve the information on Richard P Hollstrom Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.