NPIMap

Organization Active NPI

Inmed Clinical Services LLC

Doing business as North Shore Healthcare Associates - Family Practice

  • Family Medicine Physician
  • Clayton, GA
National Provider Identifier
1033470984
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INMED CLINICAL SERVICES LLC
Doing business as
North Shore Healthcare Associates - Family Practice
Practice address
331 Ridgecrest Cir
Clayton, GA 30525-4186
Phone
(706) 782-0440
NPI assigned
Jun 6, 2012
Last updated
Jun 6, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
INMED CLINICAL SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Vicki F Lawrenson
Title
Coo
Phone
(334) 386-0343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

331 Ridgecrest Cir
Clayton, GA 30525-4186

Mailing address

PO Box 5013
Montgomery, AL 36103-5013
Phone (334) 386-0343

Other names 1

  • North Shore Healthcare Associates - Family Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Inmed Clinical Services LLC6 organizations share this tax ID, including this one
Part of
Inmed Clinical Services LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1033470984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5013",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361035013",
            "telephone_number": "334-386-0343",
            "fax_number": "334-386-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 RIDGECREST CIR",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254186",
            "telephone_number": "706-782-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INMED CLINICAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INMED CLINICAL SERVICES LLC",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "LAWRENSON",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "334-386-0343"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Healthcare Associates - Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clayton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.