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

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

Organization subpart

Yes

Parent organization

WEST END MEDICAL CENTERS, INCAs reported in NPPES

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

Authorized official

Name

Dr. Michael W Brooks, MD

Title

Chief Opertaing Officer

Phone

(404) 752-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 8

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

• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Morrow, GA
  • NPI 1285353946

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Marietta, GA
  • NPI 1285727396

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Rome, GA
  • NPI 1417597238

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1720080989

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Douglasville, GA
  • NPI 1720692783

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1760612055

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1770202426

  O20040413000807

  Same enrollment
• The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1790404457

  O20040413000807

  Same enrollment

Part of

West End Medical Centers the Family Health Center Bolton Village

Locations

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000437478D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Cobb Specialty Pharmacy Inc
• West Cobb Specialty Pharmacy Inc
• West End Medical Centers at Allen Road
• West End Medical Centers Inc
• West End Medical Centers, Inc
• West End Well Werks LLC
• West Family Chiropractic
• West Paces Ambulatory Surgical Center, LLC
• West Paces Anesthesia Services, LLC
• West Paces Surgery Center LLC

• All providers in Atlanta, GA
• Federally Qualified Health Center (FQHC) in Georgia

• 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.