Athens Model Neighborhood Health Center Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Athens, GA
NPI 1053962902 · NPPES record last updated Aug 4, 2023
Key facts
- NPI
- 1053962902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ATHENS MODEL NEIGHBORHOOD HEALTH CENTER INC
- Practice address
- 870 Gaines School Rd
Athens, GA 30605-3132 - Phone
- (762) 499-6960
- NPI assigned
- Sep 23, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- HILLSMAN HEALTH CENTER
Authorized official
- Name
- Linda M Cherry
- Title
- Human Resource
- Phone
- (762) 499-6960
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 2
Practitioners 14
-
Qirrat Saleem Aamir, DMD
-
Kathryn Taylor Ashmore, LCSW
-
Kenny H Esho, M.D.
-
Donovan Audley Gowdie, D.P.M
-
Stalina Cine Gowdie, M.D.
-
Gail L Hurley, M.D.
-
Erika Nikole James, FNP
-
Amy Elizabeth Kasarla, NURSE PRACTITIONER
-
Tionya Lawrence, NP
-
Melissa Mason, NP
-
Sangita Yadav, MD
-
Daphne C Esho, MD
-
Brittany Rogers, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040525001064 | GA | Part B Supplier - Clinic/Group Practice | 0042291270 |
Receives reassigned benefits from 15 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Athens, GA |
National Provider Directory
- Tax ID family
- Athens Neighd HLTH Ctr
- Part of
- Athens Neighd HLTH Ctr
Locations
3320 Old Jefferson Rd
Ste 300D
Athens, GA 30607
Phone (706) 850-9041
870 Gaines School Rd
Athens, GA 30605
Phone (706) 546-7473
135 Athens West Pkwy
Athens, GA 30606
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
870 Gaines School Rd
Athens, GA 30605-3132
Mailing address
PO Box 147
Athens, GA 30603-0147
Phone (762) 499-6960
Other names
- Hillsman Health Center
Other providers in Athens, GA
- Athens Medical and Rehabilitative Services Inc
- Athens Medical Arts Pharmacy Inc
- Athens Medical Arts Pharmacy Inc
- Athens Medical Associates PC
- Athens Medical Solutions LLC
- Athens Model Neighborhood Health Center Inc
- Athens Model Neighborhood Health Center Inc
- Athens Model Neighborhood Health Center Inc
- Athens Neighborhood Diagnostic Center
- Athens Neighborhood Health Center Inc
All providers in Athens, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.