NPIMap

Organization Active NPI

The Emory Clinic Inc

Doing business as Integrated Memory Care Clinic

  • Geriatric Medicine (Family Medicine) Physician
  • Atlanta, GA
National Provider Identifier
1891516753
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
THE EMORY CLINIC INC
Doing business as
Integrated Memory Care Clinic
Practice address
57 Executive Park South NE Ste 160
Atlanta, GA 30329-2248
Phone
(404) 712-6929
NPI assigned
Oct 22, 2024
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Adam Tribbett
Title
VP, Ehc MKT SRVC & Ehn Ehi Med
Phone
(404) 778-5294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary

Addresses

Primary practice location

57 Executive Park South NE Ste 160
Atlanta, GA 30329-2248

Mailing address

2201 Henderson Mill Rd NE Ste 160
Atlanta, GA 30345-2711
Phone (404) 778-5079

Other names 1

  • INTEGRATED MEMORY CARE CLINIC Doing business as

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
11D2308153Integrated Memory Care Emory Clinic57 Executive Park Drive, Suite 100, Atlanta, GA 30329Certificate of waiverJul 22, 2026
11D2324756Emory Clinic Dermatology at Ep57, the57 Executive Park Drive, NE, Suite 190, Atlanta, GA 30329Provider-performed microscopyMay 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Emorty Clinic Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

57 Executive Park South NE
Ste 160
Atlanta, GA 30329
Phone (404) 712-6929

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1891516753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HENDERSON MILL RD NE STE 160",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452711",
            "telephone_number": "404-778-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 EXECUTIVE PARK SOUTH NE STE 160",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292248",
            "telephone_number": "404-712-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EMORY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "TRIBBETT",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "VP, EHC MKT SRVC & EHN  EHI MED",
        "authorized_official_telephone_number": "404-778-5294"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRATED MEMORY CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.