Anthony John Pothoulakis, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

072758 Issued in GA

Practice address

475 Philip Blvd Ste 100
Lawrenceville, GA 30046-8736

Phone

(770) 995-3300

Fax

(770) 995-3307

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gwinnett Clinic LTD

  dba Gwinnett Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, GA
  • NPI 1629117650
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Miami Valley Cardiologists Inc.

  • Cardiovascular Disease Physician
  • Dayton, OH
  • NPI 1538168083
  NPD (past)
• Northwest Advance Cardiology,Inc.

  • Cardiovascular Disease Physician
  • Lima, OH
  • NPI 1801962022
  NPD (past)
• Professional Readers Group, Inc

  • Specialist
  • Cincinnati, OH
  • NPI 1861445702
  NPD (past)
• Samaritan Emergency Corp

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1922084136
  NPD (past)
• The Dayton Heart Center, Inc.

  • Cardiovascular Disease Physician
  • Dayton, OH
  • NPI 1558363762
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1548269012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MEDLOCK BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PHILIP BLVD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468736",
            "telephone_number": "770-995-3300",
            "fax_number": "770-995-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHOULAKIS",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "072758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003151345",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Porras, MD
• Marie Catherine Porras, OTD, OTR/L
• Ta'Shay Shanee Porter, ACSW
• Lillian Portillo, RPH
• Positive Influences Counseling LLC
• Chad Potts, BCPC
• Angela Powell-Smith, ED.D., LPC,
• Anethia Schwann Powell
• Tessa Powell, PT, DPT
• Jennifer Lee Powers, PHARMD

• Cardiovascular Disease Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; 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.