Medlink Georgia Inc
Organization Active NPI Radiology Clinic/Center · Winder, GA
NPI 1750860508 · NPPES record last updated Jul 24, 2023
Key facts
- NPI
- 1750860508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- MEDLINK GEORGIA INC
- Practice address
- 137 W Athens St Ste 104
Winder, GA 30680-1786 - Phone
- (770) 867-6633
- NPI assigned
- Aug 13, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- MEDLINK GEORGIA INC
Authorized official
- Name
- Dave Ward
- Title
- Ceo
- Phone
- (706) 788-3234
Corporate family (same tax ID) 45
Practitioners 15
-
Mayukh Babu, MD
-
Vernon W. Barrow III, M.D.
-
Dennis M Burton, M.D.
-
Aamer Z. Farooki, M.D.
-
Matthew Howard Greenspan, M.D.
-
Vaughn Marshall, MD
-
Philip B. McDonald, M.D.
-
Jawad M Nesheiwat, M.D.
-
Tisha Singer, MD
-
Vikram Krishan Sobti, M.D.
-
Glenn A Tuckman, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2288226 | Medlink Winder Imaging Center | Certificate of waiver | Aug 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
All facility ownership & control disclosures 11
| Facility | Type | Role | Since |
|---|---|---|---|
| Medlink Habersham |
Federally qualified health center | Operational/Managerial Control | Jan 13, 2014 |
| Medlink Monroe |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 5, 2023 |
| Medlink Danielsville |
Federally qualified health center | Operational/Managerial Control (100%) | Jan 14, 2022 |
| Medlink Winder Womens Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 1, 2016 |
| Medlink Commerce |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 8, 2018 |
| Medlink Jefferson |
Federally qualified health center | Operational/Managerial Control (100%) | Mar 1, 2021 |
| Medlink Suches |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 20, 2021 |
| Medlink Cleveland |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2021 |
| Medlink Georgia Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2022 |
| Medlink Oconee |
Federally qualified health center | Operational/Managerial Control (100%) | Apr 22, 2023 |
| Medlink Athens |
Federally qualified health center | Operational/Managerial Control (100%) | Aug 3, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231024000476 | GA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 3274442850 | Practice locations: Winder, GA |
National Provider Directory
- Tax ID family
- Oglethorpe Family Medic
- Part of
- Oglethorpe Family Medic
Locations
137 W Athens St
Ste 104
Winder, GA 30680
Phone (770) 744-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Yes |
Addresses
Primary practice location
137 W Athens St Ste 104
Winder, GA 30680-1786
Mailing address
PO Box 459
Colbert, GA 30628-0459
Phone (706) 788-3234
Other names
- MedLink Winder Imaging
Other providers in Winder, GA
- Raheen McRae
- Karen McWhorter
- Medical & Mental Holistic Healthcare
- Robin Medina
- Medlink Georgia Inc
- Medlink Georgia Inc
- Medlink Georgia, Inc
- Medlink Georgia, Inc
- Medlink Georgia, Inc
- Betsy O Mejias
All providers in Winder, GA · Radiology Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.