Active NPI
Relymd Virtual Health Ga, LLC
- Emergency Medicine Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- RELYMD VIRTUAL HEALTH GA, LLC
- Practice address
- 5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834 - Phone
- (770) 874-5400
- NPI assigned
- Jan 8, 2024
- 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
- Kim Larsen
- Title
- Director of Credentialing
- Phone
- (770) 874-5400
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Hospitalist Physician | 208M00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834
Mailing address
5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834
Phone (770) 874-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, LA, CO, MI, FL, MA, NY, GA, VA, UT, TX, ID, CA, NJ, HI, SC, AZ, NH
Enrollment records 18
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240709001364 | PA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Philadelphia, PA |
| O20240710003661 | LA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: New Orleans, LA |
| O20240721000046 | CO | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 3 practitioners Practice locations: Denver, CO; Boulder, CO; Loveland, CO |
| O20240723003532 | MI | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Iron River, MI |
| O20240726000080 | FL | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 7 practitioners Practice locations: Jacksonville Beach, FL; Thonotosassa, FL; Parkland, FL; Miami, FL; Gulf Breeze, FL; Boca Raton, FL |
| O20240729001775 | MA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Sudbury, MA |
| O20240729001945 | NY | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Hammondsport, NY |
| O20240809000635 | GA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 9 practitioners Practice locations: Kennesaw, GA; Smyrna, GA; Roswell, GA; Marietta, GA; Decatur, GA; Atlanta, GA |
| O20241120004368 | VA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 2 practitioners Practice locations: Ashburn, VA; Leesburg, VA |
| O20241206002012 | UT | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Santa Clara, UT |
| O20250107002682 | TX | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: El Paso, TX |
| O20250110002830 | ID | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Hailey, ID |
| O20250113002709 | CA | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 4 practitioners Practice locations: Calabasas, CA; Lemon Grove, CA; San Francisco, CA |
| O20250401002472 | NJ | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Cresskill, NJ |
| O20250506003197 | HI | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 6 practitioners Practice locations: Honolulu, HI; Mililani, HI |
| O20251031004235 | SC | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Johns Island, SC |
| O20260407000785 | AZ | Part B Supplier - Clinic/Group Practice | 2466997945 | Practice locations: Parker, AZ |
| O20260520002089 | NH | Part B Supplier - Clinic/Group Practice | 2466997945 |
Receives reassigned benefits from 1 practitioner Practice locations: Nashua, NH |
National Provider Directory
National Provider DirectoryLocations
22421 Barton Rd
#21301
Grand Terrace, CA 92313
Phone (949) 201-9995
518 Julia St
New Orleans, LA 70130
Phone (415) 271-7300
25 Trafalgar Sq
Nashua, NH 03063
Practitioners & affiliated clinicians
Practitioners 43
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Atlanta, GA
- NPI 1881937001
Emergency Medicine, GA
-
- Emergency Medicine Physician
- Walterboro, SC
- NPI 1639178064
Emergency Medicine, SC
-
- Emergency Medicine Physician
- Winter Haven, FL
- NPI 1689014920
Emergency Medicine, FL
-
- Interventional Pain Medicine Physician
- Totowa, NJ
- NPI 1336487834
Emergency Medicine, FL
-
- Emergency Medicine Physician
- Los Angeles, CA
- NPI 1558357723
CA, Emergency Medicine
-
- Internal Medicine Physician
- Sterling, VA
- NPI 1306194667
Emergency Medicine, VA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1704672000000",
"number": "1386414720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 NEW NORTHSIDE DR STE 320",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285834",
"telephone_number": "770-874-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 NEW NORTHSIDE DR STE 320",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285834",
"telephone_number": "770-874-5400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RELYMD VIRTUAL HEALTH GA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-02",
"status": "A",
"authorized_official_last_name": "LARSEN",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
"authorized_official_telephone_number": "770-874-5400"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"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 Jan 8, 2024; 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.