Medical Centre of Conyers

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MEDICAL CENTRE OF CONYERS

Practice address

1445 Old McDonough Hwy SE Ste E
Conyers, GA 30094-5977

Phone

(770) 922-9222

Fax

(770) 922-8794

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Stephen F Felton, MDNPI 1841285327

Title

President

Phone

(770) 922-9222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Tax ID family

Medical Centre2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medical Centre

  • Legal Medicine
  • Conyers, GA
  • NPI 1932379666
  NPD tax ID

Locations

Practitioners 6

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

• Stephen F Felton, M.D.

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1841285327
  Medicare reassignment Authorized official
• Jason Berendt, MD

  • Internal Medicine Physician
  • Conyers, GA
  • NPI 1245266782
  Medicare reassignment NPD
• Grant Thomas Land, PA-C

  • Medical Physician Assistant
  • Conyers, GA
  • NPI 1508816570
  NPD
• Deveane Tatanya Atkinson, NP

  • Family Nurse Practitioner
  • Conyers, GA
  • NPI 1275053340
  NPD (past)
• Jana Allen Fuller, N.P.

  • Nurse Practitioner
  • Conyers, GA
  • NPI 1588920524
  NPD (past)
• Timothy Morris, PA

  • Physician Assistant
  • Conyers, GA
  • NPI 1396173837
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1710946371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 OLD MCDONOUGH HWY SE STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945977",
            "telephone_number": "770-922-9222",
            "fax_number": "770-922-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 OLD MCDONOUGH HWY SE STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945977",
            "telephone_number": "770-922-9222",
            "fax_number": "770-922-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTRE OF CONYERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "FELTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-922-9222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medcura Health, Inc.
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• Medi Home Therapy LLC (Medi Caregivers Home Therapy)
• Medical Arts Health Care, LLC (Omnicare of Atlanta #48233)
• Medical Centre
• Medical Wellness Care LLC
• Medifleet Transport
• Priyaben S Mehta, PHARM. D
• Ingrid Meier, PT
• Alexis Mejia, PA

• Clinic/Center in Conyers, GA
• Providers in Conyers, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.