Santa Rosa Clinic, PA

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

050406 Issued in GA

Legal business name

SANTA ROSA CLINIC, PA

Practice address

1200 E Walnut Ave
Suite #4
Dalton, GA 30721-4196

Phone

(706) 259-5579

Fax

(706) 259-6558

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Director

Phone

(706) 259-5579

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Santa Rosa Clinic PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Santa Rosa Clinic, PA

  • Adult Day Care Clinic/Center
  • Calhoun, GA
  • NPI 1407094212
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Santa Rosa Clinic, PA

  • Adult Day Care Clinic/Center
  • Calhoun, GA
  • NPI 1407094212
  NPPES parent name

Practitioners 4

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

• Juan Carlos Malpartida, M.D.

  • Internal Medicine Physician
  • Dalton, GA
  • NPI 1568551919
  Medicare reassignment NPD Authorized official
• German Jose Garcia, MD

  • Internal Medicine Physician
  • Dalton, GA
  • NPI 1942393327
  NPD (past)
• Pablo E Perez, MD

  • Internal Medicine Physician
  • Dalton, GA
  • NPI 1942218086
  NPD (past)
• Santiago Willman Calderon Perez, MD

  • Infectious Disease Physician
  • Palm Coast, FL
  • NPI 1790755759
  NPD (past)

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1437332699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WALNUT AVE",
            "address_2": "SUITE #4",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307214196",
            "telephone_number": "706-259-5579",
            "fax_number": "706-259-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WALNUT AVE",
            "address_2": "SUITE #4",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307214196",
            "telephone_number": "706-259-5579",
            "fax_number": "706-259-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "MALPARTIDA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "DIRECTOR",
        "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": "050406",
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "GA",
            "license": "053528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300034256F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342515362A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "849865610-A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Sanders, FNP
• Muhammad Aslam Sandvi, MD
• Stacey Sanhueza
• Henry William Sanicola III, MD
• Daniella Eva Sankovic, MD
• Kevin Paul Sanu, MD
• Rocco Sarli Jr., PT
• William Saunders III, CRNA
• Jennifer Sawyer, MA, LPC
• Mary Darnell H Scafe, M.A., CCC-A

• Adult Day Care Clinic/Center in Dalton, GA
• Providers in Dalton, GA by specialty
• Adult Day Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.

Verify at the official NPI Registry.