Medside Palliative Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MEDSIDE PALLIATIVE CARE

Practice address

3384 Peachtree Rd NE
Atlanta, GA 30326-1181

Phone

(404) 633-7433

Fax

(888) 633-7430

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Yuliya Korabelnikova, RN

Title

Cha/Administrator

Phone

(404) 633-7433

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Medside Doing business as

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1689790867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190996",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311190996",
            "telephone_number": "404-633-7433",
            "fax_number": "888-633-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3384 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261181",
            "telephone_number": "404-633-7433",
            "fax_number": "888-633-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSIDE PALLIATIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "KORABELNIKOVA",
        "authorized_official_first_name": "YULIYA",
        "authorized_official_title_or_position": "CHA/ADMINISTRATOR",
        "authorized_official_telephone_number": "404-633-7433",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00849527A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDSIDE HOME CARE AGENCY",
            "identifier": "060-R-0068",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID LICENSE",
            "identifier": "0606-245-H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1306858121",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.