NPIMap

Organization Active NPI

Emory Medical Care Foundation Inc

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1073779591
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
EMORY MEDICAL CARE FOUNDATION INC
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 778-5014
Fax
(404) 778-4819
NPI assigned
Aug 4, 2008
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Dorothy Cook-Walter
Title
Director
Phone
(404) 778-5014

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X
Obesity Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0002X
Forensic Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084F0202X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X
Psychosomatic Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0015X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Pain Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P2900X
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084S0012X

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

101 W Ponce de Leon Ave
Decatur, GA 30030-2542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000968 GA Part B Supplier - Clinic/Group Practice 4981501814 Receives reassigned benefits from 2,723 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlanta, GA; Sandy Springs, GA; Decatur, GA

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1073779591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-778-5014",
            "fax_number": "404-778-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMORY MEDICAL CARE FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "COOK-WALTER",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-778-5014"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.