Medsouth Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

022956 Issued in GA

Legal business name

MEDSOUTH ASSOCIATES PC

Practice address

483 Upper Riverdale Rd SW Ste G
Riverdale, GA 30274-2584

Phone

(770) 996-9400

Fax

(770) 991-2918

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Richard WrightNPI 1770573552

Title

Office Manager

Phone

(770) 996-9400

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 3

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

• Richard I Wright, MD

  • Internal Medicine Physician
  • Riverdale, GA
  • NPI 1770573552
  Medicare reassignment Care Compare group NPD Authorized official
• Paul L Harvey, MD

  • Internal Medicine Physician
  • Riverdale, GA
  • NPI 1053410357
  Medicare reassignment Care Compare group NPD
• Eloy Edilberto Diaz Sr., M.D.

  • Internal Medicine Physician
  • Riverdale, GA
  • NPI 1063461051
  Medicare reassignment NPD

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1508057589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE G",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742584",
            "telephone_number": "770-996-9400",
            "fax_number": "770-991-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE G",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742584",
            "telephone_number": "770-996-9400",
            "fax_number": "770-991-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOUTH ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-996-9400"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "022956",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "036647",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046927",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000897949A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000252238A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000892581F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "003004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "149377",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "855141",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica McIntyre, DDS
• Kendra L McLester, CNM
• Eric McNeil
• Sydney Monet McTier
• Med South Associates PC 2 LLC
• Jada Wingo Metcalf
• Metro Atlanta Counseling Services, Inc.
• Tanya Michelle Meziere, M.D.
• Middle Georgia Emergency Group, LLC
• Rao S Mikkilineni, M.D.

• Internal Medicine Physician in Riverdale, GA
• Providers in Riverdale, 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 12, 2020; 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.