Individual provider Active NPI

Mikhail Gorokhov, M.D.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1922116599
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039353 Issued in GA
Practice address
2910 N Druid Hills Rd NE
Ste a
Atlanta, GA 30329-3919
Phone
(404) 320-6050
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039353 GA Primary

Addresses

Primary practice location

2910 N Druid Hills Rd NE
Ste a
Atlanta, GA 30329-3919

Mailing address

2012 Harobi Dr
Ste B
Tucker, GA 30084-5161
Phone (404) 320-6050

Other identifiers 1

IdentifierTypeStateIssuer
00662219EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206000818 GA Practitioner - Family Practice 9133316920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Clinic, PC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

1861 Peeler Rd
Ste 100
Dunwoody, GA 30338
Phone (770) 730-5800

6330 Primrose Hill Ct
Peachtree Corners, GA 30092
Phone (770) 309-8108

2362 Main St
Tucker, GA 30084
Phone (770) 938-1266

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1922116599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HAROBI DR",
            "address_2": "STE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845161",
            "telephone_number": "404-320-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 N DRUID HILLS RD NE",
            "address_2": "STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293919",
            "telephone_number": "404-320-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOROKHOV",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "039353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00662219E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.