Athens Clarke Medical Enterprises LLC
Organization Active NPI Emergency Medicine Physician · Athens, GA
NPI 1295370542 · NPPES record last updated Feb 4, 2020
Key facts
- NPI
- 1295370542
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- ATHENS CLARKE MEDICAL ENTERPRISES LLC
- Practice address
- 1230 Baxter St
Athens, GA 30606-3712 - Phone
- (706) 389-3000
- NPI assigned
- Nov 11, 2019
- Organization subpart
- No
Authorized official
- Name
- Neal A Priest, MD
- Title
- Medical Director
- Phone
- (706) 207-9960
Other NPIs on the same Medicare enrollment 1
Practitioners 77
-
Kalli Pelar Coleman Addison, ATC/LAT, EMT-I
-
Harold Adam Gage, MD
-
Brandon Hicks, M.D.
-
William Bradford Johnson, M.D.
-
Solomon John Leggett, DNP-FNP-BC
-
Barbara Fay Long, NP
-
Jason K Lowe, D.O.
-
Susan Byrnes Podolsky, M.D., M.P.P.
-
Kirby Raney, FNP-C
-
Michael Skelton, MD
-
Jonathan Swanson, M.D.
-
William Stanley Thompson, M.D.
-
Holly Ann Thornton, FNP-C
-
Katherine Diane Young, FNP C
-
Bradford Wayne Burgess, D.O.
-
Lewis Dabbs Earnest, M.D.
-
Doreen Mary Massey, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200324000216 | GA | Part B Supplier - Clinic/Group Practice | 0547698680 |
Receives reassigned benefits from 75 practitioners 1 other NPI on this enrollment Practice locations: Athens, GA; Greensboro, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
1230 Baxter St
Athens, GA 30606-3712
Mailing address
5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834
Phone (770) 874-5400
Other providers in Athens, GA
- Athens Attentive MD, LLC
- Athens Bone and Joint PC
- Athens Cardiology Group
- Athens Chiropractic & Therapy
- Athens Chiropractic Healthcare, LLC
- Athens Community Council on Aging, Inc.
- Athens Concussion & Neuropsychology Center
- Athens Counseling & Psychotherapy, LLC
- Athens Custom Meds Inc
- Athens Dentistry for Children
All providers in Athens, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.