Kim Patrice Eubanks, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

055484 Issued in GA

Practice address

465 Winn Way Ste 231
Decatur, GA 30030-1723

Phone

(347) 262-3054

NPI assigned

May 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Meharry Medical College School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

CTD Network LLCGroup PAC ID 4486025087, 27 clinicians

Genetics Medical Group PLLCGroup PAC ID 5597235259, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CTD Network LLC

  • Multi-Specialty Clinic/Center
  • Plant City, FL
  • NPI 1851039762

  AL

  Medicare reassignment Care Compare group NPD
• Carespot of Orlando Hsi Urgent Care LLC

  dba CareSpot Urgent Care / CareSpot - Clermont

  • Urgent Care Clinic/Center
  • Orlando, FL
  • NPI 1306367503

  Family Medicine

  Medicare reassignment NPD
• Hma/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Vero Beach, FL
  • NPI 1689812109
  Medicare reassignment NPD
• Shands/Solantic Joint Venture, LLC

  • Urgent Care Clinic/Center
  • Gainesville, FL
  • NPI 1558595223
  Medicare reassignment NPD
• Solantic of Jacksonville, LLC

  dba CareSpot Express Healthcare

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100

  Family Medicine

  Medicare reassignment NPD
• Solantic/South Florida, LLC

  dba CareSpot Express Healthcare

  • Urgent Care Clinic/Center
  • Coral Springs, FL
  • NPI 1851344378
  Medicare reassignment NPD
• West Boynton Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Boynton Beach, FL
  • NPI 1003172628

  Family Medicine

  Medicare reassignment NPD
• SG Medical Professional PC

  • Family Medicine Physician
  • Staten Island, NY
  • NPI 1457085615

  FL

  Medicare reassignment
• Genetics Medical Group PLLC

  • Internal Medicine Physician
  • Helena, MT
  • NPI 1891651675
  Care Compare group
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093765521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 10TH ST NW # 231",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185713",
            "telephone_number": "347-262-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WINN WAY STE 231",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301723",
            "telephone_number": "347-262-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "KIM",
        "middle_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "26227",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "055484",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "199994",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Lynn Essex, LCSW
• Ebenezer Essuman, PHARMD
• Kaprice Estelle
• Valencia Etienne-Marseille, APRN,FNP-C
• Mireille Etienne, LPC
• Anne T Evans, MS RN CS
• Bonnie Manaskie Evans, PHARMD
• C. Simone Evans, D.C.
• Chloe Diane Evans, D.O.
• Deja Evans, RBT

• Family Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.