Clarkston Community Health Center, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CLARKSTON COMMUNITY HEALTH CENTER, INC.

Practice address

3700 Market St
Suite E-1
Clarkston, GA 30021-2653

Phone

(678) 359-2060

NPI assigned

Jun 20, 2015

Last updated

Jun 20, 2015By 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

Mr. Saeed Raees

Title

Ceo

Phone

(404) 512-9675

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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.

• Kimberley Anne Crawford, PHD, MPH, RN, FNP-C

  • Family Nurse Practitioner
  • Clarkston, GA
  • NPI 1013792852
  NPD (past)

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

{
    "created_epoch": "1434758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434758400000",
    "number": "1629450143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 MARKET ST",
            "address_2": "SUITE E-1",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212653",
            "telephone_number": "678-359-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 MARKET ST",
            "address_2": "SUITE E-1",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212653",
            "telephone_number": "678-359-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-20",
        "last_updated": "2015-06-20",
        "status": "A",
        "authorized_official_last_name": "RAEES",
        "authorized_official_first_name": "SAEED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-512-9675",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourtney Danielle Chang, FNP-C
• Eunice Li Chay, DMD, MPH
• Huei-Chen Cheng, LPC
• Mariya George Cheriyampurathu
• Patrice Gibson Chishom, MD
• Clarkston Family Medicine
• Clarkston Primary & Urgent Care, LLC
• Marqueta A Coffer
• Corinthianhomwcareservices (HomeCareServices)
• Kimberley Anne Crawford, PHD, MPH, RN, FNP-C

• Primary Care Clinic/Center in Clarkston, GA
• Providers in Clarkston, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.