Northlake Urgent Care Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

NORTHLAKE URGENT CARE INC

Practice address

4060 Lavista Rd
Tucker, GA 30084-5216

Phone

(404) 231-7643

Fax

(404) 237-1764

NPI assigned

Sep 13, 2019

Last updated

Dec 29, 2022By 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. Maria Latanya Walker, MDNPI 1548213366

Title

Ceo

Phone

(404) 231-7643

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

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.

• Maria Latanya Walker, MD

  • Family Medicine Physician
  • Decatur, GA
  • NPI 1548213366
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1528618220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 LAVISTA RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845216",
            "telephone_number": "404-231-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 LAVISTA RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845216",
            "telephone_number": "404-231-7643",
            "fax_number": "404-237-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE URGENT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LATANYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-231-7643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Medical Center, LLC (Northlake Medical Center)
• Northlake Multispecialty Associates LLC
• Northlake Physician Practice Network Inc
• Northlake Physician Practice Network, Inc. (Women's Cancer Alliance)
• Northlake Women's Specialists
• Northland Hearing Centers, Inc (NuEar Hearing Center)
• Now: New Opportunities Waiting
• Hannah Nowland
• Noel Noya Pino

• Urgent Care Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Urgent Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.