Salam Clinic Primary and Urgent Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SALAM CLINIC PRIMARY AND URGENT CARE

Practice address

5468 Memorial Dr Ste D
Stone Mountain, GA 30083-3267

Phone

(404) 963-2142

Fax

(404) 963-2098

NPI assigned

Sep 16, 2024

Organization subpart

No

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

Authorized official

Name

Selamawit Mola, FNPNPI 1619673944

Title

Manager

Phone

(469) 355-5339

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Selamawit Mola, FNP

  • Family Nurse Practitioner
  • Stone Mountain, GA
  • NPI 1619673944
  Medicare reassignment NPD Authorized official
• Etsubdenke Areaya, NP

  • Nurse Practitioner
  • Stone Mountain, GA
  • NPI 1790233120
  Medicare reassignment NPD

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1023845880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5468 MEMORIAL DR STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833267",
            "telephone_number": "404-963-2142",
            "fax_number": "404-963-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5468 MEMORIAL DR STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833267",
            "telephone_number": "404-963-2142",
            "fax_number": "404-963-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALAM CLINIC PRIMARY AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "MOLA",
        "authorized_official_first_name": "SELAMAWIT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-355-5339",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Sagoes
• Abyalew T Sahlie
• Samuels Health Services,LLC
• Delena Sanders, CD(DONA)
• Latasha Quiauna Sandidge, RN
• Marie Sanon Deltour, LPN
• Stephanie Claire Saulsbury, RBT

• Primary Care Clinic/Center in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.