Curtis David Malcom, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

070494 Issued in GA

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(770) 535-3611

Fax

(770) 535-7092

NPI assigned

Apr 23, 2010

Last updated

Aug 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: curtis.malcom@longstreetclinic.gadirect.net

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.

• Northeast Georgia Community Physicians LLC

  dba Longstreet of NGHS

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977

  Pediatrics

  Medicare reassignment NPD
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1770800377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-535-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "GA",
            "postal_code": "305114000",
            "country_code": "US",
            "telephone_number": "706-776-2368",
            "fax_number": "706-776-2589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175630",
            "country_code": "US",
            "telephone_number": "678-207-4200",
            "fax_number": "770-533-4771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4019 Executive Drive",
            "address_purpose": "LOCATION",
            "city": "Oakwood",
            "state": "GA",
            "postal_code": "305663433",
            "country_code": "US",
            "telephone_number": "770-533-6500",
            "fax_number": "770-533-6543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4095 S Lee St",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305183647",
            "country_code": "US",
            "telephone_number": "770-932-8519",
            "fax_number": "770-533-4798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALCOM",
        "first_name": "CURTIS",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "070494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Robert Mahan
• Amber D Mahek, ACNP
• Hussain Majeed, MD
• Jaime Majors, FNP
• Brooklyne Marlowe Makaya, M.D.
• Malone Foot and Ankle, LLC
• Maria Malone, DPM
• Michael James Maloney, M.D.
• Hemalata Mandiga, DO
• Dev Mangalat, MD

• Pediatrics Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.