Magnolia Medical Clinic, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MAGNOLIA MEDICAL CLINIC, P.C.

Practice address

1235 Indian Trail Road
Suite 200
Norcross, GA 30093

Phone

(770) 931-1333

Fax

(770) 931-3111

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Suresh H Shah, M.D.NPI 1629097472

Title

Owner/Physician

Phone

(770) 931-1333

Specialties & licenses 2

Addresses

Other names 1

• Norcross Medical Clinic, Magnolia Medical Clinic Other name

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

Locations

Practitioners 10

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

• Suresh Hirji Shah, MD

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1629097472
  Medicare reassignment Care Compare group NPD Authorized official
• Ravi Suresh Shah, M.D.

  • Internal Medicine Physician
  • Norcross, GA
  • NPI 1215381710
  Medicare reassignment Care Compare group NPD
• Shehnaz Makhani, MD

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1720088511
  Medicare reassignment NPD
• Anita Patel

  • Primary Care Nurse Practitioner
  • Norcross, GA
  • NPI 1306548284
  Medicare reassignment NPD
• Bijalben Patel, FNP

  • Family Nurse Practitioner
  • Norcross, GA
  • NPI 1003472150
  Medicare reassignment NPD
• Shashank Chandulal Patel, MD

  • Pulmonary Disease Physician
  • Norcross, GA
  • NPI 1598716995
  Medicare reassignment NPD
• Marie L White, PA-C

  • Physician Assistant
  • Jackson, GA
  • NPI 1710138680
  Medicare reassignment
• Emily Juliette Gaines, PA-C

  • Medical Physician Assistant
  • Duluth, GA
  • NPI 1528713716
  NPD (past)
• Fatu Secka, FNP-C

  • Family Nurse Practitioner
  • Duluth, GA
  • NPI 1578259701
  NPD (past)
• Mohammad Abous Sabur-Nasiri, MD

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1205878675
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1184711517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1553",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-931-1333",
            "fax_number": "770-931-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 INDIAN TRAIL ROAD",
            "address_2": "SUITE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30093",
            "telephone_number": "770-931-1333",
            "fax_number": "770-931-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "770-931-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norcross Medical Clinic, Magnolia Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Macky Enterprises P.C. (Norcross Pain Management Clinic)
• Macky Enterprises P.C.
• Macky Enterprises PC (Peachtree Childrens Clinic)
• Macs LTC Pharmacy Georgia LLC (Macs LTC Pharmacy Georgia)
• Haricharanteja Madduri
• Cortney Jo Maholtz, CCC-SLP
• Majl Diagnostic Laboratories LLC
• Monali N. Majmudar, PHARMD
• Jerin Jahan Malik
• Maloms Group International, LLC.

• Internal Medicine Physician in Norcross, GA
• Providers in Norcross, 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 May 28, 2015; 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.