Gadecatur SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GADECATUR SNF LLC

Practice address

304 Fifth Ave
Decatur, GA 30030-4812

Phone

(404) 373-6231

NPI assigned

Sep 27, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Gerald Phillip Stoll

Title

MBR

Phone

(917) 836-0436

Specialties & licenses 1

Addresses

Other names 1

• East Lake Arbor Doing business as

Practitioners 2

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

• Terence Andrew Frinks, M.D.

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1285761833
  NPD (past)
• Kirpich Joseph, M.D.

  • Family Medicine Physician
  • Lilburn, GA
  • NPI 1750373023
  NPD (past)

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1295210904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 BIRCHWOOD DR",
            "city": "HUNTINGTN STA",
            "state": "NY",
            "postal_code": "117463922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 FIFTH AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304812",
            "telephone_number": "404-373-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GADECATUR SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "STOLL",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "917-836-0436",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Lake Arbor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Lake Arbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tara Gaddis, LMSW
• Tracey Marie Gagne, LPC
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• Megan Gainer, AU.D.
• Demetria Curtis Gaines, PHARMD, BCPS
• Marylynn Gaines

• Skilled Nursing Facility in Decatur, GA
• Providers in Decatur, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.