Conyers Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CONYERS INTERNAL MEDICINE LLC

Practice address

1380 Milstead Ave NE
Ste C
Conyers, GA 30012-3864

Phone

(770) 922-7000

NPI assigned

Feb 28, 2013

Organization subpart

No

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

Authorized official

Name

Naseem K Shakoor, MDNPI 1821109463

Title

Owner

Phone

(770) 922-7000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

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

• Naseem Shakoor, M.D.

  • Internal Medicine Physician
  • Conyers, GA
  • NPI 1821109463
  Medicare reassignment NPD Authorized official
• Katina Currin

  • Certified Registered Nurse Anesthetist
  • Marietta, GA
  • NPI 1184933939
  NPD (past)
• Mirza A Kajani, M.D.

  • Gastroenterology Physician
  • Griffin, GA
  • NPI 1306975651
  NPD (past)
• Karim K Shakoor, M.D.

  • Gastroenterology Physician
  • Conyers, GA
  • NPI 1952412579
  NPD (past)

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1063752913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "STE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "770-922-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "STE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "770-922-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONYERS INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "SHAKOOR",
        "authorized_official_first_name": "NASEEM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-922-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Conyers Pediatrics, PC
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• Conyers Smiles Dentistry, PC
• Conyers Walk in Clinic

• Internal Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.