Unimedical,PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

041874 Issued in GA

Legal business name

UNIMEDICAL,PC

Practice address

4575 Jonesboro Rd
Forest Park, GA 30297-4317

Phone

(404) 477-0849

Fax

(404) 477-0859

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ephrem Makonnen

Title

Clinic Manager

Phone

(404) 477-0849

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Son Bang Mai, FNP

  • Family Nurse Practitioner
  • Riverdale, GA
  • NPI 1174136071
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023186483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302974317",
            "telephone_number": "404-477-0849",
            "fax_number": "404-477-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302974317",
            "telephone_number": "404-477-0849",
            "fax_number": "404-477-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIMEDICAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAKONNEN",
        "authorized_official_first_name": "EPHREM",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "404-477-0849",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "041874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002511G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tho N Tran, RPH
• Connie Trieu, M.D.
• Truliant Health Systems
• Truliant Health Systems LLC and Plaza Consultants LLC a Partnership
• Trustee Drugs, Inc.
• Niambi Vantress
• Yosan Negga Vilfort, PA-C
• Vina Health Care Clinic Corporation
• Zoe Vinci
• Vital Link Transport LLC

• Specialist in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.