NPIMap

Organization Active NPI

West End Medical Centers, the Family Health Center @ Bolton Village

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
National Provider Identifier
1225041247
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
NON PROFIT EXEMPT Issued in GA
Legal business name
WEST END MEDICAL CENTERS, THE FAMILY HEALTH CENTER @ BOLTON VILLAGE
Practice address
2011 Bolton Rd NW
Suite 104
Atlanta, GA 30318-1137
Phone
(404) 752-1400
Fax
(404) 756-8749
NPI assigned
Aug 14, 2006
Last updated
Feb 8, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST END MEDICAL CENTERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Authorized official

Name
Dr. Michael W Brooks, MDNPI 1174513089
Title
Chief Opertaing Officer
Phone
(404) 752-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NON PROFIT EXEMPT GA Primary

Addresses

Primary practice location

2011 Bolton Rd NW
Suite 104
Atlanta, GA 30318-1137

Mailing address

868 York Ave SW
Atlanta, GA 30310-2750
Phone (404) 752-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000807 GA Part B Supplier - Clinic/Group Practice 2062406903 Receives reassigned benefits from 38 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rome, GA; Morrow, GA; Atlanta, GA; Marietta, GA; Douglasville, GA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
West End Medical Centers at Allen Road

Practitioners & affiliated clinicians

Practitioners 1

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1225041247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400",
            "fax_number": "404-756-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BOLTON RD NW",
            "address_2": "SUITE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303181137",
            "telephone_number": "404-752-1400",
            "fax_number": "404-756-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END MEDICAL CENTERS, THE FAMILY HEALTH CENTER @ BOLTON VILLAGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST  END MEDICAL CENTERS, INC",
        "enumeration_date": "2006-08-14",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF OPERTAING OFFICER",
        "authorized_official_telephone_number": "404-752-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": "NON PROFIT EXEMPT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.