Executive Medical Associates

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EXECUTIVE MEDICAL ASSOCIATES

Practice address

4500 Hugh Howell Rd
Building 270, Suite B
Tucker, GA 30084-4723

Phone

(770) 723-0817

Fax

(770) 723-1691

NPI assigned

Dec 31, 2009

Last updated

Dec 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lee Wilkes, M.D.NPI 1568441871

Title

Medical Director

Phone

(770) 723-0817

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Executive Medical Associates2 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.

• Executive Medical Associates P.C.

  • Clinic/Center
  • Tucker, GA
  • NPI 1104204379
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lee Wilkes, MD

  • Internal Medicine Physician
  • Tucker, GA
  • NPI 1568441871
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1518297266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 HUGH HOWELL RD",
            "address_2": "SUITE B #303",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844918",
            "telephone_number": "770-723-0817",
            "fax_number": "770-723-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 HUGH HOWELL RD",
            "address_2": "BUILDING 270, SUITE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844723",
            "telephone_number": "770-723-0817",
            "fax_number": "770-723-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "WILKES",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-723-0817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantay Smith Evans, LPCA
• Sylvia Evans
• Tavia Foster Evans, CCC-SLP
• Aleshia Evers
• Execellence in Healthcare
• Executive Medical Associates P.C.
• Express Professional Homecare,LLC.
• Eyes-Rite,Inc
• Faebris Medical & Community Education
• Brittany Fagan, LCSW

• Internal Medicine Physician in Tucker, GA
• Providers in Tucker, 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 Dec 31, 2009; 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.