Active NPI
Northlake Medical Center LLC
Doing business as Northlake Medical Center
- General Acute Care Hospital
- Tucker, GA
National Provider Identifier
1346294303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- Legal business name
- NORTHLAKE MEDICAL CENTER LLC
- Doing business as
- Northlake Medical Center
- Practice address
- 1455 Montreal Rd
Tucker, GA 30084-8100 - Phone
- (770) 270-3000
- Fax
- (770) 270-3199
- NPI assigned
- May 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Satterfield
- Title
- Cfo
- Phone
- (770) 270-3010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Primary |
Addresses
Primary practice location
1455 Montreal Rd
Tucker, GA 30084-8100
Mailing address
1455 Montreal Rd
Tucker, GA 30084-8100
Phone (770) 270-3000
Other identifiers 21
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037132200 | Medicaid | DC | |
| 10025106700 | Medicaid | NE | |
| 10809A | Medicaid | SC | |
| 158331700 | Other | DEPT OF LABOR | |
| 304783690 | Medicaid | MI | |
| EMO0033N | Medicaid | AL | |
| 200179210A | Medicaid | IN | |
| 2543117 | Medicaid | OH | |
| 00000547A | Medicaid | GA | |
| 1757811 | Medicaid | LA | |
| 3119396 | Other | TN | BLUECARE |
| 50004977 | Other | KY | PASSPORT |
| 81479600 | Medicaid | WI | |
| 010110491 | Medicaid | VA | |
| 3566 | Other | GA | BLUE CROSS |
| 410333500 | Medicaid | MD | |
| OP10033 | Medicaid | RI | |
| 2064377 | Medicaid | NY | |
| 3026168 | Medicaid | WA | |
| 883448 | Medicaid | AZ | |
| 912980400 | Medicaid | FL |
Other names 1
- Northlake Medical Center
National Provider Directory
National Provider Directory- Tax ID family
- Northlake Medical Center
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Northlake Medical Center
- Rehabilitation Hospital Unit
- Tucker, GA
- NPI 1164476123
-
dba Northlake Medical Center
- General Acute Care Hospital
- Tucker, GA
- NPI 1255385217
-
dba Northlake Medical Center
- General Acute Care Hospital
- Tucker, GA
- NPI 1396798385
-
dba Northlake Medical Center
- General Acute Care Hospital
- Tucker, GA
- NPI 1659458776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1228435200000",
"number": "1346294303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 MONTREAL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300848100",
"telephone_number": "770-270-3000",
"fax_number": "770-270-3199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 MONTREAL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300848100",
"telephone_number": "770-270-3000",
"fax_number": "770-270-3199"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHLAKE MEDICAL CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-22",
"last_updated": "2008-12-05",
"status": "A",
"authorized_official_last_name": "SATTERFIELD",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "770-270-3010"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037132200",
"state": "DC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025106700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10809A",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "158331700",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "304783690",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EMO0033N",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200179210A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2543117",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00000547A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1757811",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE",
"identifier": "3119396",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "50004977",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81479600",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010110491",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "3566",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "410333500",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OP10033",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2064377",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3026168",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "883448",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "912980400",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northlake Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tucker, GA
- North Star of Georgia Counseling
- Christopher Pollard North, D.M.D.
- Northeast Atlanta Associates in Gastroenterology
- Northlake Endoscopy Center
- Northlake Internal Medicine
- Northlake Medical Center, LLC (Northlake Medical Center)
- Northlake Medical Center, LLC (Northlake Medical Center)
- Northlake Medical Center, LLC (Northlake Medical Center)
- Northlake Medical Center, LLC (Northlake Medical Center)
- Northlake Multispecialty Associates LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.