Organization Active NPI

Next Level Medical Management, LLC

Doing business as Family Medical Center

  • Family Medicine Physician
  • Griffin, GA
National Provider Identifier
1750996070
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEXT LEVEL MEDICAL MANAGEMENT, LLC
Doing business as
Family Medical Center
Practice address
1657 N Expressway
Griffin, GA 30223-1276
Phone
(770) 228-2641
NPI assigned
Sep 14, 2020
Last updated
Sep 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Kristin Gore, MDNPI 1831327923
Title
Owner
Phone
(770) 228-2641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1657 N Expressway
Griffin, GA 30223-1276

Mailing address

1657 N Expressway
Griffin, GA 30223-1276
Phone (770) 228-2641

Other practice location 1

1669 N Expressway
Griffin, GA 30223-1274
Phone (678) 408-6418

Other names 1

  • Family Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201116002393 GA Part B Supplier - Clinic/Group Practice 0547671984 Receives reassigned benefits from 8 practitioners
Practice locations: Griffin, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0899223Next Level Medical Management, LLC1657 North Expressway, Griffin, GA 30223Certificate of waiverNov 30, 2027
11D2108676Next Level Medical Management, LLC1669 North Expressway, Griffin, GA 30223Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory

Locations

1657 N Expressway
Griffin, GA 30223
Phone (770) 228-2641

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1750996070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 N EXPRESSWAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231276",
            "telephone_number": "770-228-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 N EXPRESSWAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231276",
            "telephone_number": "770-228-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1669 N Expressway",
            "address_purpose": "LOCATION",
            "city": "Griffin",
            "state": "GA",
            "postal_code": "302231274",
            "country_code": "US",
            "telephone_number": "678-408-6418",
            "fax_number": "678-408-6425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEXT LEVEL MEDICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-228-2641",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.