Inner Community Health
Organization Active NPI Psychiatry Physician · Duluth, GA
NPI 1891398541 · NPPES record last updated Nov 7, 2023
Key facts
- NPI
- 1891398541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- INNER COMMUNITY HEALTH
- Practice address
- 2180 Satellite Blvd Ste 400
Duluth, GA 30097-4927 - Phone
- (800) 620-6950
- Fax
- (877) 290-0408
- NPI assigned
- Nov 17, 2020
- Organization subpart
- No
Authorized official
- Name
- Mirica Sanders, DO
- Title
- Owner
- Phone
- (216) 577-3441
Practitioners 19
-
Sefiatu Abu, PMHNP-BC
-
Quinshunda Lanet Carter, PMHNP
-
Tansha Enoch, PMHNP
-
Susan O Furro, FNP-C; PMHNP-BC
-
Shaquanda Shantivus Gordon, PMHNP-BC
-
Glory Osadiaye, PMHNP, MSN, BSN, RN
-
Mariam Qureshi, M.D.
-
Kenosha Latrice Tillman, NURSE PRACTITIONER
-
Mirica Artine Sanders, D.O.
-
Marilyn Rankin, NP
-
Steve Sanders, CDCA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230823000046 | GA | Part B Supplier - Clinic/Group Practice | 8729441852 |
Receives reassigned benefits from 17 practitioners Practice locations: Duluth, GA; Riverdale, GA |
National Provider Directory
Locations
10700 Medlock Bridge Rd
Ste 104
Johns Creek, GA 30097
Phone (770) 476-9885
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Clinical Social Worker |
1041C0700X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
2180 Satellite Blvd Ste 400
Duluth, GA 30097-4927
Mailing address
2180 Satellite Blvd Ste 400
Duluth, GA 30097-4927
Other practice location 1
223 Medical Center Dr
Riverdale, GA 30274-2640
Phone (800) 620-6950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003291824A | Medicaid | GA |
Other providers in Duluth, GA
- Imr Immediate Care, LLC
- In-Sight Psych LLC
- Independent Physical Therapy of Ga, LLC
- Infinite Laboratories Ga LLC
- Christina Ingram
- Innovex Diagnostic Solutions LLC
- Inspire Hospice and Palliative Care, Inc.
- Insured Health Care Company
- Integrity Business Management, LLC
- Laurel Ip
All providers in Duluth, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.