NPIMap

Organization Active NPI

Medlife Urgent Care LLC

  • Urgent Care Clinic/Center
  • McDonough, GA
National Provider Identifier
1083249114
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDLIFE URGENT CARE LLC
Practice address
345 Huntington Place CT Ste 200
McDonough, GA 30253-8651
Phone
(404) 271-3775
NPI assigned
Mar 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Riddhi S Merchant, MDNPI 1588827513
Title
MD/Co-Owner
Phone
(404) 271-3775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

345 Huntington Place CT Ste 200
McDonough, GA 30253-8651

Mailing address

345 Huntington Place CT Ste 200
McDonough, GA 30253-8651

Other practice location 1

5825 Buford Hwy
Norcross, GA 30071-2545
Phone (404) 271-3775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604002308 GA Part B Supplier - Clinic/Group Practice 4789005463 Receives reassigned benefits from 38 practitioners
Practice locations: Norcross, GA; Winder, GA; McDonough, GA; Flowery Branch, GA; Conyers, GA; Buford, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2214330Medlife Urgent Care5825 Buford Highway, Suite 300, Norcross, GA 30071Certificate of waiverFeb 21, 2027

National Provider Directory

National Provider Directory

Locations

2129 Friendship Rd
Ste 200
Buford, GA 30519
Phone (770) 209-2787

4038 Winder Hwy
Ste 100
Flowery Branch, GA 30542
Phone (770) 209-2787

4038 Winder Hwy
Ste 200
Flowery Branch, GA 30542
Phone (770) 209-2787

345 Huntington Place Ct
Ste 200B
McDonough, GA 30253
Phone (678) 993-0820

345 Huntington Place Ct
#200
McDonough, GA 30253
Phone (404) 271-3775

5825 Buford Hwy
Norcross, GA 30071
Phone (404) 271-3775

Practitioners & affiliated clinicians

Practitioners 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1083249114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT STE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT STE 200",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "404-271-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5825 Buford Hwy",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300712545",
            "country_code": "US",
            "telephone_number": "404-271-3775",
            "fax_number": "678-796-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDLIFE URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "MERCHANT",
        "authorized_official_first_name": "RIDDHI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MD/CO-OWNER",
        "authorized_official_telephone_number": "404-271-3775",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.