Internal Medicine Associates of West Atlanta, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

062400 Issued in GA

Legal business name

INTERNAL MEDICINE ASSOCIATES OF WEST ATLANTA, P.C.

Practice address

939 Bob Arnold Blvd
Ste F
Lithia Springs, GA 30122-3258

Phone

(770) 739-2440

Fax

(770) 819-8808

NPI assigned

Nov 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Donell Nelson, M.D.NPI 1669696829

Title

Owner/President

Phone

(770) 739-2440

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.

• Shannon Donell Nelson, MD

  • Internal Medicine Physician
  • Lithia Springs, GA
  • NPI 1669696829
  Medicare reassignment NPD Authorized official
• Tomas J Chao, PA

  • Medical Physician Assistant
  • Woodstock, GA
  • NPI 1316003577
  NPD (past)
• Alan M Gardner, M.D.

  • Dermatology Physician
  • Marietta, GA
  • NPI 1215048673
  NPD (past)
• Aimee M Mitchell, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Canton, GA
  • NPI 1578784013
  NPD (past)
• Casey Kim Powell, PA-C

  • Surgical Physician Assistant
  • Suwanee, GA
  • NPI 1437345782
  NPD (past)

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481414400000",
    "number": "1902183205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 BOB ARNOLD BLVD",
            "address_2": "STE F",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223258",
            "telephone_number": "770-739-2440",
            "fax_number": "770-819-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 BOB ARNOLD BLVD",
            "address_2": "STE F",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223258",
            "telephone_number": "770-739-2440",
            "fax_number": "770-819-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF WEST ATLANTA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2016-12-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "DONELL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "770-739-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "062400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2016; 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.