Medlink Georgia Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MEDLINK GEORGIA INC

Practice address

11 Charlie Morris Rd
Colbert, GA 30628-2445

Phone

(706) 788-3234

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

David Ward, PHD

Title

Ceo

Phone

(706) 788-3234

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: syed.zaidi1@gadirect.net
• Direct secure messaging: nailah.abdulbaaqee1@gadirect.net
• Direct secure messaging: jeralyn.smith1@gadirect.net
• Direct secure messaging: rhonda.frazier@gadirect.net
• Direct secure messaging: kathryn.mccusker1@gadirect.net

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 117

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

• Mushtaq Ahmed, M.D.

  • Family Medicine Physician
  • Winder, GA
  • NPI 1457592552
  Medicare reassignment Care Compare group NPD
• Mohammed R Ahmeduddin, DPM

  • Podiatrist
  • Lawrenceville, GA
  • NPI 1295998722
  Medicare reassignment Care Compare group NPD
• Maria Alban, MD

  • Family Medicine Physician
  • Snellville, GA
  • NPI 1396857587
  Medicare reassignment Care Compare group NPD
• Ernie Loza Aldaco, FNP

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1689009953
  Medicare reassignment Care Compare group NPD
• Denise Atkins, N.P.

  • Family Nurse Practitioner
  • Lexington, GA
  • NPI 1497136576
  Medicare reassignment Care Compare group NPD
• Lee Lindsey Bleshoy, DNP, NP-C, FNP-BC

  • Family Nurse Practitioner
  • Winder, GA
  • NPI 1669636767
  Medicare reassignment Care Compare group NPD
• Caroline Broom

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1912370990
  Medicare reassignment Care Compare group NPD
• Brenna Clinansmith, FNP-C

  • Family Nurse Practitioner
  • Monroe, GA
  • NPI 1336887595
  Medicare reassignment Care Compare group NPD
• Karla Coco

  • Family Nurse Practitioner
  • Colbert, GA
  • NPI 1235977489
  Medicare reassignment Care Compare group NPD
• Monick Crain, FNP-C

  • Family Nurse Practitioner
  • Jefferson, GA
  • NPI 1639802473
  Medicare reassignment Care Compare group NPD
• Tracy Ellen Dasher

  • Mental Health Counselor
  • Clayton, GA
  • NPI 1457815136
  Medicare reassignment Care Compare group NPD
• Amy Davidson, WHNP-BC

  • Women's Health Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1295273571
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1396794541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234",
            "fax_number": "706-788-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHARLIE MORRIS RD",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306282445",
            "telephone_number": "706-788-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINK GEORGIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-788-3234",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014RK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA868",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Tara Johnson-Huff, RN
• John S. Kahle
• Elizabeth Broman Long, MD
• Med South EMS Inc
• Medlink Georgia Inc
• Medlink Georgia Inc
• Medlink Georgia Inc
• Bridgett Muckle, LCSW
• Jorie Muraida, DO
• Cassie Myers, CNA

• Federally Qualified Health Center (FQHC) in Colbert, GA
• Providers in Colbert, GA by specialty
• Federally Qualified Health Center (FQHC) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.