Organization Active NPI

Mt Zion Urgent Care Center LLC

  • Urgent Care Clinic/Center
  • Jonesboro, GA
National Provider Identifier
1376928903
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
043534 Issued in GA
Legal business name
MT ZION URGENT CARE CENTER LLC
Practice address
2759 Mount Zion Pkwy
Suite D
Jonesboro, GA 30236-2568
Phone
(770) 880-6924
NPI assigned
Jul 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Authorized official

Name
Dr. Oluropo A Ayeni, M.DNPI 1275572190
Title
MD/Director
Phone
(770) 880-6924

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
Urgent Care Clinic/Center 261QU0200X 043534 GA Primary

Addresses

Primary practice location

2759 Mount Zion Pkwy
Suite D
Jonesboro, GA 30236-2568

Mailing address

2759 Mount Zion Pkwy
Suite D
Jonesboro, GA 30236-2568
Phone (770) 880-6924

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161102001392 GA Part B Supplier - Clinic/Group Practice 4284912866 Receives reassigned benefits from 1 practitioner
Practice locations: Jonesboro, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2103318Mt Zion Urgent Care Ctr LLC2759 Mount Zion Parkway, Ste D, Jonesboro, GA 30236Certificate of waiverOct 8, 2027

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": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1376928903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 MOUNT ZION PKWY",
            "address_2": "SUITE D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362568",
            "telephone_number": "770-880-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 MOUNT ZION PKWY",
            "address_2": "SUITE D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362568",
            "telephone_number": "770-880-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT ZION URGENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "AYENI",
        "authorized_official_first_name": "OLUROPO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD/DIRECTOR",
        "authorized_official_telephone_number": "770-880-6924",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "043534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.