Winder Internal Medicine and Geriatrics Center PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

063592 Issued in GA

Legal business name

WINDER INTERNAL MEDICINE AND GERIATRICS CENTER PC

Practice address

30 Satellite Dr
Suite 100
Winder, GA 30680-6211

Phone

(770) 586-0310

Fax

(770) 586-0312

NPI assigned

Mar 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Rasha G Al Samara, MD

Title

President

Phone

(770) 586-0310

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Stephanie Kutchback, NP

  • Family Nurse Practitioner
  • Winder, GA
  • NPI 1710358502
  NPD (past)
• Kimtuyen Ngoc Nguyen, MD

  • Pulmonary Disease Physician
  • Gastonia, NC
  • NPI 1114118486
  NPD (past)

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1447573845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SATELLITE DR",
            "address_2": "SUITE 100",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306806211",
            "telephone_number": "770-586-0310",
            "fax_number": "770-586-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SATELLITE DR",
            "address_2": "SUITE 100",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306806211",
            "telephone_number": "770-586-0310",
            "fax_number": "770-586-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDER INTERNAL MEDICINE AND GERIATRICS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "AL SAMARA",
        "authorized_official_first_name": "RASHA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-586-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "063592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "063592",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Winder EMS
• Winder ENT Center
• Winder Eye Care Center
• Winder Hma Inc
• Winder Hma LLC
• Winder Medical PA
• Winder Nursing Inc
• Winder Surgical Specialist
• Michelle D Winham, ATC
• Jennifer Won, D.D.S.

• All providers in Winder, GA
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.