Internal Medicine Consultants, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

059633 Issued in GA

Legal business name

INTERNAL MEDICINE CONSULTANTS, P.C.

Practice address

206 E Broad St
Winder, GA 30680

Phone

(770) 867-3208

Fax

(770) 867-3218

NPI assigned

Feb 15, 2008

Last updated

Sep 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles N Ekinde, MD

Title

Doctor

Phone

(770) 867-3208

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1316115025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX B",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306800137",
            "telephone_number": "770-867-3208",
            "fax_number": "770-867-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E BROAD ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "30680",
            "telephone_number": "770-867-3208",
            "fax_number": "770-867-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE CONSULTANTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "EKINDE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-867-3208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "059633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "635315149A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "511I110352",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Winder, GA
• Providers in Winder, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.