Park Springs LLC
A Medicare group practice based in Stone Mountain, GA: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 7810961380), with 8 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 7810961380
- Provider type
- Part A Provider - Skilled Nursing Facility, Part B Supplier - Clinic/Group Practice
- Enrolled in
- GA
- Enrollments
- 2
- Group size
- 4 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 2
Enrollment records 2
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20041203000292 | GA | Part B Supplier - Clinic/Group Practice | 1962628669 |
| O20140102001638 | GA | Part A Provider - Skilled Nursing Facility | 1184605693 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Park Springs, LLC
dba Pebblebrook Health Center at Park Springs
- Skilled Nursing Facility
- Stone Mountain, GA
- NPI 1184605693
-
Park Springs, LLC
dba Park Springs Wellness Clinic
- Health Service Clinic/Center
- Stone Mountain, GA
- NPI 1962628669
Practice locations
- Stone Mountain, GA2
Clinicians 8
Clinicians who reassign their Medicare benefits to this group (8) or whom Care Compare lists as members (4).
-
Eleni Andria Footman, MD
- Internal Medicine Physician
- Tucker, GA
- NPI 1164835005
-
Jacobe Hollis, MSN, APRN, NP-C
- Family Nurse Practitioner
- Atlanta, GA
- NPI 1457714677
-
Khurram A Khan, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Stone Mountain, GA
- NPI 1063677011
-
Sadaf Khan, MD
- Geriatric Medicine (Family Medicine) Physician
- Columbus, OH
- NPI 1528453842
-
Joash Theophilus Lazarus, M.D.
- Neurology Physician
- Atlanta, GA
- NPI 1720374754
-
Shonda Moore, RN
- Family Nurse Practitioner
- Atlanta, GA
- NPI 1477070084
-
Hyung Seok Oh, MD
- Geriatric Medicine (Family Medicine) Physician
- Macon, GA
- NPI 1780944835
-
Traci Larue Switzer, NP
- Adult Health Nurse Practitioner
- Atlanta, GA
- NPI 1851732598
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.