Simon Paulos Yohannes

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

98743 Issued in GA

Practice address

101 Quartz Dr Ste 101
Villa Rica, GA 30180-3256

Phone

(770) 836-9445

Fax

(770) 836-8808

NPI assigned

Apr 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Pittsburgh School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

TMC Immediate Care, IncGroup PAC ID 9133105976, 22 clinicians

Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: syohannes2879608@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment Care Compare group NPD
• TMC Immediate Care, Inc

  dba Tanner Urgent Care

  • Urgent Care Clinic/Center
  • Villa Rica, GA
  • NPI 1386708097
  Medicare reassignment Care Compare group NPD
• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Primary Care

  • Family Medicine Physician
  • Rome, GA
  • NPI 1689610149
  Medicare reassignment NPD
• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Specialty Pharmacy

  • Specialty Pharmacy
  • Rome, GA
  • NPI 1548056468
  NPD
• Grady Memorial Hospital Corporation

  dba Grady Inpatient Rehabilitation Unit

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1740819846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR STE 101",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803256",
            "telephone_number": "770-836-9445",
            "fax_number": "770-836-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 10th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319013601",
            "country_code": "US",
            "telephone_number": "706-571-1430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOHANNES",
        "first_name": "SIMON",
        "middle_name": "PAULOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "98743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodall Orthodontics
• Harold Steve Woodall, D.D.S.
• Steven Niles Woodall, D.M.D.
• Hannah Yates
• Alexandra Yazdani
• Vadietrich Zachery-Phillips, PHARMD

• Family Medicine Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.