NPIMap

Organization Active NPI

Saint Joseph'S Mercy Care Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
National Provider Identifier
1003058967
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAINT JOSEPH'S MERCY CARE SERVICES, INC.
Practice address
200 Hannover Park Rd Ste 100
Atlanta, GA 30350-1899
Phone
(678) 843-8500
Fax
(678) 843-8601
NPI assigned
Mar 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thomas E. Andrews
Title
President
Phone
(678) 843-8503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X GA Primary

Addresses

Primary practice location

200 Hannover Park Rd Ste 100
Atlanta, GA 30350-1899

Mailing address

424 Decatur St SE
Atlanta, GA 30312-1848
Phone (678) 843-8600

Other names 1

  • Saint Joseph's Mercy Care - Mary Hall Freedom House Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050516000862 GA Part B Supplier - Clinic/Group Practice 9931191525 Receives reassigned benefits from 62 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlanta, GA; Chamblee, GA

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1003058967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 DECATUR ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121848",
            "telephone_number": "678-843-8600",
            "fax_number": "678-843-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HANNOVER PARK RD STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303501899",
            "telephone_number": "678-843-8500",
            "fax_number": "678-843-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH'S MERCY CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-843-8503",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Joseph's Mercy Care - Mary Hall Freedom House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.