NPIMap

Organization Active NPI

Lakewood Health Center

  • Public Health or Welfare Agency
  • Atlanta, GA
National Provider Identifier
1508914995
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LAKEWOOD HEALTH CENTER
Practice address
1855 Jonesboro Road SE
Atlanta, GA 30315
Phone
(404) 624-0626
Fax
(404) 624-0636
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Steven R Katkowsky, MD
Title
Health Director
Phone
(404) 730-1202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1855 Jonesboro Road SE
Atlanta, GA 30315

Mailing address

99 Jesse Hill Jr Drive RM 402
Atlanta, GA 30303
Phone (404) 730-1217

Other identifiers 1

IdentifierTypeStateIssuer
0000518843MedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Fulton County Government7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1855 Jonesboro Rd SE
Atlanta, GA 30315
Phone (404) 624-0626

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508914995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JESSE HILL JR DRIVE RM 402",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-730-1217",
            "fax_number": "404-730-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 JONESBORO ROAD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30315",
            "telephone_number": "404-624-0626",
            "fax_number": "404-624-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KATKOWSKY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "404-730-1202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000518843",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.