NPIMap

Organization Active NPI

Georgia Clinic Patient Outreach LLC

  • Internal Medicine Physician
  • Norcross, GA
National Provider Identifier
1225709843
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GEORGIA CLINIC PATIENT OUTREACH LLC
Doing business as
Georgia clinic patient outreach llc
Practice address
6330 Primrose Hill CT # 108
Norcross, GA 30092-4544
Phone
(770) 903-0144
NPI assigned
Sep 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Miss Nina D Shah
Title
Manger
Phone
(404) 820-1017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6330 Primrose Hill CT # 108
Norcross, GA 30092-4544

Mailing address

6330 Primrose Hill CT # 108
Norcross, GA 30092-4544
Phone (770) 903-0144

Other practice location 1

6330 Primrose Hill Ct # 108
Norcross, GA 30092-4544
Phone (770) 903-0144

Other names 1

  • Georgia clinic patient outreach llc Doing business as

National Provider Directory

National Provider Directory

Locations

6330 Primrose Hill Ct
#108
Norcross, GA 30092
Phone (770) 903-0144

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1225709843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 PRIMROSE HILL CT # 108",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924544",
            "telephone_number": "770-903-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 PRIMROSE HILL CT # 108",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924544",
            "telephone_number": "770-903-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 Primrose Hill Ct # 108",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300924544",
            "country_code": "US",
            "telephone_number": "770-903-0144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA CLINIC PATIENT OUTREACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "404-820-1017",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia clinic patient outreach llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.