NPIMap

Organization Active NPI

Recovery Consultants of Atlanta, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tucker, GA
National Provider Identifier
1851482376
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RECOVERY CONSULTANTS OF ATLANTA, INC.
Practice address
1957 Lakeside Pkwy Ste 510
Tucker, GA 30084-5859
Phone
(404) 289-0313
Fax
(404) 289-0314
NPI assigned
Sep 28, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Ms. Cassandra Collins, LCSWNPI 1467089409
Title
Ceo
Phone
(404) 289-0313

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X GA Primary
Clinical Medical Laboratory 291U00000X 11D1020819 GA

Addresses

Primary practice location

1957 Lakeside Pkwy Ste 510
Tucker, GA 30084-5859

Mailing address

PO Box 479
Avondale Estates, GA 30002-0479
Phone (404) 289-0313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160125002497 GA Part A Provider - Federally Qualified Health Center (FQHC) 1456654417 Practice locations: Tucker, GA
O20170215001854 GA Part B Supplier - Clinic/Group Practice 1456654417 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Decatur, GA; Tucker, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851482376. Details of each certification follow.

Federally qualified health center certification: CCN 111026

Legal name
RECOVERY CONSULTANTS OF ATLANTA, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 25, 2016
Last certification
Jan 25, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 9, 2000 in GA
Enrollment address
1957 Lakeside Pkwy
Ste 510
Tucker, GA 30084-5859

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
11D1020819Recovery Consultants of Atlanta1957 Lakeside Parkway, Suite 510, Tucker, GA 30084Certificate of waiverJan 5, 2028

National Provider Directory

National Provider Directory

Locations

3423 Covington Dr
Ste B
Decatur, GA 30032
Phone (404) 284-6061

1957 Lakeside Pkwy
Ste 510
Tucker, GA 30084
Phone (404) 289-0313

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Raymond H Lewis Individual Corporate OfficerBoard Chairman Apr 30, 2008
Kelvin B Turner Individual Corporate OfficerTreasurer Oct 1, 2012
Cassandra Collins Individual Corporate Director Jan 1, 2022
W-2 Managing EmployeeExecutive Director/Ceo Aug 4, 2002

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1851482376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300020479",
            "telephone_number": "404-289-0313",
            "fax_number": "404-289-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 LAKESIDE PKWY STE 510",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845859",
            "telephone_number": "404-289-0313",
            "fax_number": "404-289-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY CONSULTANTS OF ATLANTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-289-0313",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D1020819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.