NPIMap

Organization Active NPI

Santa Rosa Clinic, PA

  • Adult Day Care Clinic/Center
  • Calhoun, GA
National Provider Identifier
1407094212
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
50406 Issued in GA
Legal business name
SANTA ROSA CLINIC, PA
Practice address
355 Richardson Rd SE Ste 6
Calhoun, GA 30701-3681
Phone
(706) 625-2237
Fax
(706) 625-2239
NPI assigned
Feb 2, 2009
Last updated
Feb 2, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SANTA ROSA CLINIC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Authorized official

Name
Dr. Juan Carlos Malpartida, MDNPI 1568551919
Title
Owner
Phone
(706) 259-5579

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 53528 GA
Adult Day Care Clinic/Center 261QA0600X 50406 GA Primary

Addresses

Primary practice location

355 Richardson Rd SE Ste 6
Calhoun, GA 30701-3681

Mailing address

355 Richardson Rd SE Ste 6
Calhoun, GA 30701-3681
Phone (706) 625-2237

Other identifiers 2

IdentifierTypeStateIssuer
342515362AMedicaidGA
849865610-AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Santa Rosa Clinic PA2 organizations share this tax ID, including this one
Part of
Santa Rosa Clinic PA

Other organizations with this tax ID 1

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

Locations

355 Richardson Rd SE
Ste 6
Calhoun, GA 30701
Phone (706) 625-2237

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1407094212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 RICHARDSON RD SE STE 6",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013681",
            "telephone_number": "706-625-2237",
            "fax_number": "706-625-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RICHARDSON RD SE STE 6",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013681",
            "telephone_number": "706-625-2237",
            "fax_number": "706-625-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTA ROSA CLINIC, PA",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "MALPARTIDA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-259-5579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "GA",
            "license": "53528",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "GA",
            "license": "50406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342515362A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "849865610-A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.