The Longstreet Clinic, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE LONGSTREET CLINIC, PC

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(770) 718-1122

Fax

(770) 533-4786

NPI assigned

Jan 31, 2006

Last updated

May 27, 2021By 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

Amelia Lowe Collins

Title

Ceo

Phone

(770) 718-1122

Specialties & licenses 14

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPPES parent name
• The Longstreet Clinic, PC

  dba The Longstreet Clinic Dept of Pathology/Interlab

  • Clinical Medical Laboratory
  • Gainesville, GA
  • NPI 1003052416
  NPPES parent name

Practitioners 202

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexander David Allaire, MD

  • Maternal & Fetal Medicine Physician
  • Gainesville, GA
  • NPI 1669578282
  Medicare reassignment Care Compare group NPD
• Richard Browning Allen, MD

  • Diagnostic Radiology Physician
  • Savannah, GA
  • NPI 1407801210

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Jennifer Kelly Anderson, MD

  • Medical Oncology Physician
  • Gainesville, GA
  • NPI 1457748451

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Rebecca Bedingfield Ando, MD

  • Obstetrics & Gynecology Physician
  • Gainesville, GA
  • NPI 1396988754
  Medicare reassignment Care Compare group NPD
• Holly Lynn Archer, FNP-BC

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1740268101
  Medicare reassignment Care Compare group NPD
• Maurice Alexander Asouzu, MD

  • Surgery Physician
  • Gainesville, GA
  • NPI 1972063394
  Medicare reassignment Care Compare group NPD
• Jose Fernando Aycinena Goicolea, MD

  • Colon & Rectal Surgery Physician
  • Gainesville, GA
  • NPI 1245495787
  Medicare reassignment Care Compare group NPD
• Robert Brett Barger, MD

  • Obstetrics & Gynecology Physician
  • Gainesville, GA
  • NPI 1699754887
  Medicare reassignment Care Compare group NPD
• Brett Chandler Baudin, M.D.

  • Diagnostic Radiology Physician
  • Gainesville, GA
  • NPI 1871550988
  Medicare reassignment Care Compare group NPD
• Ryan Darrell Berry, MD, PHD

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1154881118
  Medicare reassignment Care Compare group NPD
• Kayleigh Dyches Biskup, FNP-C

  • Nurse Practitioner
  • Gainesville, GA
  • NPI 1144909839

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Kimberly Patton Blasingame, CNM

  • Advanced Practice Midwife
  • Gainesville, GA
  • NPI 1184662280
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1326019977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LONGSTREET CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "LOWE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-718-1122"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.