NPIMap

Organization Active NPI

Godel First Medical Clinics Inc.

Doing business as Godel First Medical Clinic

  • Clinic/Center
  • Stone Mountain, GA
National Provider Identifier
1558665653
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GODEL FIRST MEDICAL CLINICS INC.
Doing business as
Godel First Medical Clinic
Practice address
1525 E Park Place Blvd
Suite 300
Stone Mountain, GA 30087-3453
Phone
(770) 879-7707
Fax
(770) 879-7708
NPI assigned
Jan 4, 2011
Last updated
Dec 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Ellis Ifeanyichukwu Efobi, MDNPI 1144487018
Title
Ceo
Phone
(770) 879-7707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1525 E Park Place Blvd
Suite 300
Stone Mountain, GA 30087-3453

Mailing address

1525 E Park Place Blvd
Suite 300
Stone Mountain, GA 30087-3453
Phone (770) 879-7707

Other identifiers 1

IdentifierTypeStateIssuer
594981959AMedicaidGA

Other names 1

  • Godel First Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1558665653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E PARK PLACE BLVD",
            "address_2": "SUITE 300",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873453",
            "telephone_number": "770-879-7707",
            "fax_number": "770-879-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E PARK PLACE BLVD",
            "address_2": "SUITE 300",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873453",
            "telephone_number": "770-879-7707",
            "fax_number": "770-879-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GODEL FIRST MEDICAL CLINICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "EFOBI",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_middle_name": "IFEANYICHUKWU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-879-7707",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594981959A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Godel First Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.