Athens Geriatrics and Internal Medicine, PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

049200 Issued in GA

Legal business name

ATHENS GERIATRICS AND INTERNAL MEDICINE, PC

Practice address

1500 Oglethorpe Ave
Suite 3200
Athens, GA 30606-2179

Phone

(706) 549-8931

Fax

(706) 549-0088

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Jerome Paradela, M.D.NPI 1437131596

Title

President

Phone

(706) 549-8931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 5

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.

• Mark Jerome Paradela, MD

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1437131596
  Medicare reassignment Care Compare group NPD Authorized official
• May Luz Falcon Bullecer, M.D.

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1265500862

  Geriatric Medicine

  Medicare reassignment Care Compare group NPD
• Lisa Anne Swift, APRN

  • Adult Health Nurse Practitioner
  • Tucker, GA
  • NPI 1982803995
  Medicare reassignment Care Compare group NPD
• Kshawnda Frazier, DNP, FNP-BC

  • Family Nurse Practitioner
  • Snellville, GA
  • NPI 1053082115

  Single Specialty

  Medicare reassignment NPD
• Melissa Spinelli Tolbert, NP-C

  • Adult Health Nurse Practitioner
  • Athens, GA
  • NPI 1558047506
  Medicare reassignment NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891918934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 3200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-549-8931",
            "fax_number": "706-549-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 3200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-549-8931",
            "fax_number": "706-549-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS GERIATRICS AND INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARADELA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-549-8931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "049200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Athens, GA
• Providers in Athens, GA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.