Gamd PCP Medical Group LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

GAMD PCP MEDICAL GROUP LLC

Practice address

5473 Old Floyd Rd SW
Mableton, GA 30126-2203

Phone

(480) 824-8446

NPI assigned

Jan 17, 2025

Organization subpart

No

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

Authorized official

Name

Kwasi Badu

Title

Manager

Phone

(480) 824-8446

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Kenneth A Munnerlyn, MD

  • Neurology Physician
  • Chicago, IL
  • NPI 1316172513

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1689485799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 OLD FLOYD RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262203",
            "telephone_number": "480-824-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 OLD FLOYD RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262203",
            "telephone_number": "480-824-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMD PCP MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "BADU",
        "authorized_official_first_name": "KWASI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-824-8446"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valleria Deanna Forney-Williams, LCSW
• Sophia Elizabeth Franklin, LCSW
• Heather Renee Freeman
• Gab Rich Psychotherapy LLC
• Mara Ivanka Galic, MHSC, RD
• Jennifer Garrett
• Gentle Rose Home Care LLC (Gentle Rose Home Care)
• Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy #02187)
• Georgia Life Healthcare, LLC
• Cooper True Geralds

• Community Health Clinic/Center in Mableton, GA
• Providers in Mableton, GA by specialty
• Community Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.