Organization Active NPI

Clairmont Medical Clinic LLC Belachew Yohannes a Ei Al MBR

  • Primary Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1659552115
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CLAIRMONT MEDICAL CLINIC LLC BELACHEW YOHANNES A EI AL MBR
Practice address
3490 Clairmont Rd
Atlanta, GA 30319
Phone
(404) 477-1218
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Yohannes A Belachew, MDNPI 1871586693
Title
Owner
Phone
(404) 477-1218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X GA
Primary Care Clinic/Center 261QP2300X GA Primary

Addresses

Primary practice location

3490 Clairmont Rd
Atlanta, GA 30319

Mailing address

3490 Clairmont Rd NE
Atlanta, GA 30319-3758
Phone (404) 477-1218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000363 GA Part B Supplier - Clinic/Group Practice 7214904630 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1059979Clairmont Medical Clinic3490 Clairmont Road, Atlanta, GA 30319Certificate of waiverOct 11, 2026

National Provider Directory

National Provider Directory

Locations

3490 Clairmont Rd NE
Brookhaven, GA 30319
Phone (404) 477-1218

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659552115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 CLAIRMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193758",
            "telephone_number": "404-477-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 CLAIRMONT RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "404-477-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIRMONT MEDICAL CLINIC LLC BELACHEW YOHANNES A EI AL MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BELACHEW",
        "authorized_official_first_name": "YOHANNES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-477-1218",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.