North Gwinnett Healthcare, LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

NORTH GWINNETT HEALTHCARE, LLC

Practice address

5557 Aviemore CT
Suwanee, GA 30024-7524

Phone

(404) 390-5587

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Emem Udo, MDNPI 1801073465

Title

Owner

Phone

(404) 390-5587

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Emem Udo, MD

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1801073465
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1285356386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5557 AVIEMORE CT",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247524",
            "telephone_number": "404-390-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5557 AVIEMORE CT",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247524",
            "telephone_number": "404-390-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GWINNETT HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "UDO",
        "authorized_official_first_name": "EMEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-390-5587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.