NPIMap

Organization Active NPI

Comprehensive Internal Medicine at Northside

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1679917835
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE
Practice address
960 Johnson Ferry Rd NE
Suite 543
Atlanta, GA 30342-1631
Phone
(678) 205-9004
NPI assigned
Apr 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Authorized official

Name
Dr. Jacqueline T Pearson, MD, MS
Title
MD Owner
Phone
(678) 205-9004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

960 Johnson Ferry Rd NE
Suite 543
Atlanta, GA 30342-1631

Mailing address

11975 Morris Rd
Suite 140
Alpharetta, GA 30005-4419
Phone (678) 205-9004

National Provider Directory

National Provider Directory

Locations

11975 Morris Rd
Ste 140
Alpharetta, GA 30005
Phone (770) 475-4499

Practitioners & affiliated clinicians

Practitioners 3

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": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1679917835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11975 MORRIS RD",
            "address_2": "SUITE 140",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054419",
            "telephone_number": "678-205-9004",
            "fax_number": "678-205-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD NE",
            "address_2": "SUITE 543",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "678-205-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "678-205-9004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MS"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "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 May 3, 2013; 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.