Individual provider Active NPI

Sofia Ellen Edwards-Salmon, MD

  • Allergy Physician
  • Alpharetta, GA
National Provider Identifier
1053817536
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
88188 Issued in GA
Practice address
3905 Brookside Pkwy Ste 203
Alpharetta, GA 30022-4425
Phone
(678) 668-4688
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 88188 GA Primary

Addresses

Primary practice location

3905 Brookside Pkwy Ste 203
Alpharetta, GA 30022-4425

Mailing address

3905 Brookside Pkwy Ste 203
Alpharetta, GA 30022-4425

Other identifiers 1

IdentifierTypeStateIssuer
390200000XOtherGASTUDENT, HEATH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830002492 GA Practitioner - Allergy/Immunology 6507229135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Louisiana State University School of Medicine in New Orleans, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Chacko MD PCGroup PAC ID 5991040982, 3 clinicians

Practice addresses (Care Compare)

3905 Brookside Pkwy
Suite 203
Alpharetta, GA 30022-4425
Phone (678) 668-4688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88188GAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Chacko M.D. P.C Allergy CurrentSince Aug 7, 2023 Accepting new patients

Locations

3905 Brookside Pkwy
Ste 203
Alpharetta, GA 30022
Phone (678) 668-4688

17 Executive Park Dr NE
Ste 250
Atlanta, GA 30329
Phone (678) 904-4390

460 Northside Cherokee Blvd
Ste 410
Canton, GA 30115
Phone (470) 242-0730

101 Greenfield Dr
Ste 200
Cumming, GA 30040

960 Sanders Rd
Ste 500
Cumming, GA 30041
Phone (312) 576-4598

3855 Pleasant Hill Rd
Ste 420
Duluth, GA 30096
Phone (770) 495-1955

3770 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 495-0410

11315 Johns Creek Pkwy
Ste 140
Johns Creek, GA 30097

5555 Peachtree Dunwoody Rd
Ste 135
Sandy Springs, GA 30342
Phone (404) 257-0039

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFEBD/Endpoint/IAFEBD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1053817536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 BROOKSIDE PKWY STE 203",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 BROOKSIDE PKWY STE 203",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224425",
            "telephone_number": "678-668-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS-SALMON",
        "first_name": "SOFIA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "GA",
            "license": "88188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT, HEATH CARE",
            "identifier": "390200000X",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.