Fidelity Health Care Group, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038495 Issued in GA

Legal business name

FIDELITY HEALTH CARE GROUP, LLC

Practice address

950 Eagles Landing Pkwy
# 152
Stockbridge, GA 30281-7343

Phone

(703) 929-8967

Fax

(404) 601-8328

NPI assigned

Jun 18, 2015

Organization subpart

No

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

Authorized official

Name

Dr. John A Glenn Jr., MD

Title

Medical Director

Phone

(478) 290-8509

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705104000000",
    "number": "1174905830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 EAGLES LANDING PKWY",
            "address_2": "# 152",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343",
            "telephone_number": "703-929-8967",
            "fax_number": "404-601-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 EAGLES LANDING PKWY",
            "address_2": "# 152",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817343",
            "telephone_number": "703-929-8967",
            "fax_number": "404-601-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELITY HEALTH CARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "478-290-8509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "038495",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "038495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194765420",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daliah Ferguson
• Jose L. Fernandez-Gerena, MD
• Alfonso Carlos Fernandez
• Hesiri M Fernando, MD
• Rayley Dawn Ferrell
• Denise Fields, AGNP-C
• Michelle Davis Fields, MS, RD, LD
• Eric Laurence Fier, M.D.
• Channel G Filer
• Jon P Finley, M.D.

• Clinic/Center in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.