Organization Active NPI

Buckhead Medical LLC Dba Northalke Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1871914648
Registry record updated Dec 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BUCKHEAD MEDICAL LLC DBA NORTHALKE MEDICAL GROUP
Practice address
2296 Henderson Mill Rd NE
Suite 303
Atlanta, GA 30345-2739
Phone
(404) 590-4420
NPI assigned
Dec 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2013

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

Authorized official

Name
Dr. Syed RahmanNPI 1568420081
Title
Ceo
Phone
(404) 590-4420

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2296 Henderson Mill Rd NE
Suite 303
Atlanta, GA 30345-2739

Mailing address

2296 Henderson Mill Rd NE
Suite 303
Atlanta, GA 30345-2739

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140414000788 GA Part B Supplier - Clinic/Group Practice 5799917365 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

2296 Henderson Mill Rd NE
Ste 303
Atlanta, GA 30345
Phone (404) 590-4420

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387670400000",
    "number": "1871914648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE",
            "address_2": "SUITE 303",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 HENDERSON MILL RD NE",
            "address_2": "SUITE 303",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452739",
            "telephone_number": "404-590-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHEAD MEDICAL LLC DBA NORTHALKE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-22",
        "last_updated": "2013-12-22",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-590-4420",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.