Nations Medical Clinic Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NATIONS MEDICAL CLINIC INC

Practice address

3099 Bredkinridge Blvd. Suite 110
Suite 110
Duluth, GA 30096-1011

Phone

(678) 242-8035

Fax

(678) 373-1645

NPI assigned

Sep 17, 2020

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Agunobi, MDNPI 1609864446

Title

Owner

Phone

(704) 674-9147

Specialties & licenses 1

Addresses

Locations

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.

• Charles K Agunobi, M.D.

  • Internal Medicine Physician
  • Duluth, GA
  • NPI 1609864446
  Authorized official Same address or phone

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1427664333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 BREDKINRIDGE BLVD",
            "address_2": "SUITE 110",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961011",
            "telephone_number": "678-242-8035",
            "fax_number": "678-373-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 BREDKINRIDGE BLVD. SUITE 110",
            "address_2": "SUITE 110",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961011",
            "telephone_number": "678-242-8035",
            "fax_number": "678-373-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONS MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "AGUNOBI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-674-9147",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.