Complete Care Family Medicine Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMPLETE CARE FAMILY MEDICINE CLINIC LLC

Doing business as

Hillside family medicine clinic

Practice address

1685 Mars Hill Rd NW Ste 201
Acworth, GA 30101-7180

Phone

(770) 485-0031

Fax

(678) 903-4137

NPI assigned

Sep 7, 2021

Last updated

Jan 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sandeep DhaliwalNPI 1245731298

Title

MD

Phone

(770) 485-0031

Specialties & licenses 1

Addresses

Other names 1

• Hillside family medicine clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24620/brand/1/csg/1/fhir/r4

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.

• Sandeep Dhaliwal, MD

  • Family Medicine Physician
  • Acworth, GA
  • NPI 1245731298
  Medicare reassignment NPD Authorized official
• Shelley Amos, NP

  • Family Nurse Practitioner
  • Acworth, GA
  • NPI 1790354173
  Medicare reassignment NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1174292882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 MARS HILL RD NW STE 201",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017180",
            "telephone_number": "770-485-0031",
            "fax_number": "678-903-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 MARS HILL RD NW STE 201",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017180",
            "telephone_number": "770-485-0031",
            "fax_number": "678-903-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE FAMILY MEDICINE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "770-485-0031",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://hillsidefamilymedicine.org",
            "affiliation": "N",
            "address_1": "1685 Mars Hill Rd NW Ste 201",
            "city": "Acworth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301017180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hillside family medicine clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hillside family medicine clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia E Cohen, DC
• Tracie Cole, MSW
• Brianna Coleman, OTR/L
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• Comprehensive Family and Community Services, Limited
• Concierge Care Givers
• Connected Therapy Solutions of Georgia, LLC
• Rafael Alexandre Contiero, FNP-C
• Carol Cook

• Family Medicine Physician in Acworth, GA
• Providers in Acworth, 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 Jan 12, 2022; 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.