Organization Active NPI

Anytime MD Urgent Care LLC

  • Urgent Care Clinic/Center
  • Austell, GA
National Provider Identifier
1194255729
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ANYTIME MD URGENT CARE LLC
Practice address
4898 Austell Rd
Austell, GA 30106-2055
Phone
(770) 635-8407
NPI assigned
Jun 15, 2017
Last updated
Jun 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Paul Eduja, MD
Title
Authorized Official
Phone
(770) 635-8407

Specialties & licenses 1

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

Addresses

Primary practice location

4898 Austell Rd
Austell, GA 30106-2055

Mailing address

4898 Austell Rd
Austell, GA 30106-2055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180529001738 GA Part B Supplier - Clinic/Group Practice 8729343546 Receives reassigned benefits from 1 practitioner
Practice locations: Austell, 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
11D2132926Anytime MD Urgent Care4898 Austell Road, Austell, GA 30106Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

4898 Austell Rd
Austell, GA 30106
Phone (770) 635-8407

4898 Austell Rd
Ste A
Austell, GA 30106

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1194255729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4898 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301062055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4898 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301062055",
            "telephone_number": "770-635-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANYTIME MD URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "EDUJA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "770-635-8407",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.