North Atlanta Family Practice, LLC

Organization Active NPI Internal Medicine Physician · Cumming, GA

NPI 1487736138 · NPPES record last updated Dec 4, 2023

Key facts

NPI
1487736138
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
NORTH ATLANTA FAMILY PRACTICE, LLC
Practice address
1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017
Phone
(770) 844-0877
Fax
(770) 844-0891
NPI assigned
Oct 20, 2006
Organization subpart
No

Authorized official

Name
Sohel Momin, MD NPI 1760467013
Title
Ao
Phone
(770) 844-0877

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 8

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1046802North Atlanta Family Practice
1400 Northside Forsyth Dr, Cumming, GA 30041
Certificate of waiverOct 18, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051123000060 GA Part B Supplier - Clinic/Group Practice 7315967148 Receives reassigned benefits from 8 practitioners
Practice locations: Cumming, GA

National Provider Directory

Locations

2320 Atlanta Hwy
Ste 105
Cumming, GA 30040
Phone (678) 473-0715

1505 Northside Blvd
Ste 2600
Cumming, GA 30041
Phone (678) 208-0700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017

Mailing address

1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017
Phone (770) 844-0877

Other providers in Cumming, GA

All providers in Cumming, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.