Active NPI
Mikhail Gorokhov, M.D.
- Family Medicine Physician
- Atlanta, GA
National Provider Identifier
1922116599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 039353
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00662219E | Medicaid | GA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Clinic, PC | Family Medicine | Current | 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.