Immediate Care Centers of Georgia, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

056526 Issued in GA

Legal business name

IMMEDIATE CARE CENTERS OF GEORGIA, LLC

Doing business as

Immediate Care Centers, Tyrone

Practice address

190 Greencastle Rd.
Tyrone, GA 30290

Phone

(678) 895-0216

NPI assigned

Dec 24, 2007

Last updated

Sep 9, 2008By 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

Dr. Ray B Bennett, M.D.NPI 1841317138

Title

Director

Phone

(678) 895-0216

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Immediate Care Centers, Tyrone Doing business as

Practitioners 2

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.

• Ray Burnett Bennett, M.D.

  • Family Medicine Physician
  • Peachtree City, GA
  • NPI 1841317138
  NPD (past) Authorized official
• Glenn Benard McKenna, MD

  • Emergency Medicine Physician
  • Anderson, SC
  • NPI 1609941251
  NPD (past)

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1689858805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 GREENCASTLE RD.",
            "city": "TRYONE",
            "state": "GA",
            "postal_code": "30290",
            "telephone_number": "678-895-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 GREENCASTLE RD.",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "30290",
            "telephone_number": "678-895-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE CARE CENTERS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "678-895-0216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "056526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152797525A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Immediate Care Centers, Tyrone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holistic International Ministries (Dba, Him.,Inc.) (HIM.,Inc.)
• Maranda Lynn Holmes, LPC
• Idesta Medical Inc
• Jennifer Igieobo
• Nneka Kate Ikwuakolam, RBT
• Independent Physical Therapy of Ga, LLC (Benchmark PT - Tyrone)
• Farhan Islam
• Keosha Jackson, RBT
• Shawna Jackson
• Jacore Counseling (JaCore Enterprises)

• Urgent Care Clinic/Center in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Urgent Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.