South Atlanta Medical Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

035622 Issued in GA

Legal business name

SOUTH ATLANTA MEDICAL ASSOCIATES PC

Practice address

1029 Cleveland Ave
East Point, GA 30344-6719

Phone

(404) 768-4626

Fax

(404) 768-4631

NPI assigned

Feb 25, 2008

Last updated

Sep 17, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTH ATLANTA MEDICAL ASSOCIATES PCAs reported in NPPES

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

Authorized official

Name

Nicky M Battle

Title

Manager

Phone

(404) 768-4626

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• South Atlanta Medical Associates, PC

  • Internal Medicine Physician
  • East Point, GA
  • NPI 1366624520

  O20080603000000

  Same enrollment

Part of

Samuel Erinne MD

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• South Atlanta Medical Associates, PC

  • Internal Medicine Physician
  • East Point, GA
  • NPI 1366624520
  NPPES parent name

Practitioners 2

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.

• Samuel C Erinne, MD

  • Internal Medicine Physician
  • East Point, GA
  • NPI 1972555282
  NPD
• Charles Frederick Scott, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063540110
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1073782058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303446719",
            "telephone_number": "404-768-4626",
            "fax_number": "404-768-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303446719",
            "telephone_number": "404-768-4626",
            "fax_number": "404-768-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA MEDICAL ASSOCIATES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH ATLANTA MEDICAL ASSOCIATES PC",
        "enumeration_date": "2008-02-25",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "BATTLE",
        "authorized_official_first_name": "NICKY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-768-4626"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "035622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00508483G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• South Fulton Medical Center Practice Plan, LLC (South Fulton Medical Center Practice Plan)

• Internal Medicine Physician in East Point, GA
• Providers in East Point, 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 Sep 17, 2015; 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.