Family Medical Center (Holding) P.C.

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

058527 Issued in GA

Legal business name

FAMILY MEDICAL CENTER (HOLDING) P.C.

Practice address

5615 Old National Hwy
College Park, GA 30349-3811

Phone

(770) 997-2900

NPI assigned

Jul 30, 2015

Organization subpart

No

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

Authorized official

Name

Sallu Jabati, MD

Title

Ceo

Phone

(678) 559-4526

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Christiana Ezeihekaibee, FNP-C

  • Primary Care Nurse Practitioner
  • College Park, GA
  • NPI 1972952869
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1053797183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493811",
            "telephone_number": "770-997-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493811",
            "telephone_number": "770-997-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER (HOLDING) P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "JABATI",
        "authorized_official_first_name": "SALLU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-559-4526",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "GA",
            "license": "058527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "712681970B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christiana Ezeihekaibee, FNP-C
• Brianna Lee Fairley, DPT
• Faith Pharmacy Inc
• Miranda L. Fallen-Bobo, LPC, NCC
• Family and Child Interventions
• Family Medical Center P.C.
• Feed the Hungry Through Christ the King
• Fehe Enterprises
• Fehe Enterprises, Inc
• Fellowship Senior Day Care Center Inc

• Adolescent Medicine (Internal Medicine) Physician in College Park, GA
• Providers in College Park, GA by specialty
• Adolescent Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.