Organization Active NPI

Rock Health Inc

  • Primary Care Clinic/Center
  • Stone Mountain, GA
National Provider Identifier
1366082596
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ROCK HEALTH INC
Practice address
5385 Five Forks Trickum Rd Ste F
Stone Mountain, GA 30087-3018
Phone
(404) 822-4051
NPI assigned
Jan 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Ms. Kimberly R Fitzgerald, FNPNPI 1558765974
Title
Ceo/ Nurse Practitioner
Phone
(404) 822-4051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5385 Five Forks Trickum Rd Ste F
Stone Mountain, GA 30087-3018

Mailing address

382 Summer Glen CT
Stone Mountain, GA 30087-5500
Phone (404) 822-4051

Other names 1

  • Rock Primary Care & Wellness Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200811000242 GA Part B Supplier - Clinic/Group Practice 3870918626 Receives reassigned benefits from 1 practitioner
Practice locations: Stone Mountain, GA; Stone MTN, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1366082596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 SUMMER GLEN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300875500",
            "telephone_number": "404-822-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5385 FIVE FORKS TRICKUM RD STE F",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873018",
            "telephone_number": "404-822-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/ NURSE PRACTITIONER",
        "authorized_official_telephone_number": "404-822-4051",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Primary Care & Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.