NPIMap

Organization Active NPI

MSM Health Equity for All Lives Student-Run Free Clinic

  • Primary Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1356935639
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MSM HEALTH EQUITY FOR ALL LIVES STUDENT-RUN FREE CLINIC
Practice address
455 Lee St, SW
Atlanta, GA 30310
Phone
(404) 756-1209
NPI assigned
Feb 26, 2021
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MOREHOUSE HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Jasmine Bajnath
Title
Credentialing Manager
Phone
(404) 756-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

455 Lee St, SW
Atlanta, GA 30310

Mailing address

720 Westview Dr SW Ste 275550
Atlanta, GA 30310-1458
Phone (404) 756-1400

Other practice location 1

1800 Howell Mill Rd NW Ste 275550
Atlanta, GA 30318-2538
Phone (404) 756-1400

National Provider Directory

National Provider Directory
Tax ID family
MSM Health Equity for All Lives Student-Run Free Clinic9 organizations share this tax ID, including this one
Part of
MSM Health Equity for All Lives Student-Run Free Clinic

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1800 Howell Mill Rd NW
Ste 275550
Atlanta, GA 30318

720 Westview Dr SW
Ste 275550
Atlanta, GA 30310

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1356935639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW STE 275550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458",
            "telephone_number": "404-756-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEE ST, SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-756-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Howell Mill Rd NW Ste 275550",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303182538",
            "country_code": "US",
            "telephone_number": "404-756-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSM HEALTH EQUITY FOR ALL LIVES STUDENT-RUN FREE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOREHOUSE HEALTHCARE, INC.",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "BAJNATH",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "404-756-1400"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.