Ivy Falls Family Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

BL0600486 Issued in GA

Legal business name

IVY FALLS FAMILY MEDICINE

Practice address

10475 Medlock Bridge Rd
Suite 815
Duluth, GA 30097-2002

Phone

(678) 990-4828

Fax

(678) 990-4824

NPI assigned

Aug 30, 2006

Last updated

Jun 19, 2012By 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

Ms. Andrea L Sells, CMOM, CMIS,CMC

Title

Office Manager

Phone

(678) 990-4828

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADGBAA

Practitioners 2

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.

• Karen Nicole Duvall, D.O.

  • Family Medicine Physician
  • Johns Creek, GA
  • NPI 1235499724
  Medicare reassignment Care Compare group NPD
• Patrick J Voswinkel, M.D.

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1548207442
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1922118595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 815",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972002",
            "telephone_number": "678-990-4828",
            "fax_number": "678-990-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 815",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972002",
            "telephone_number": "678-990-4828",
            "fax_number": "678-990-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY FALLS FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "SELLS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-990-4828",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMOM, CMIS,CMC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "BL0600486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inspire Hospice and Palliative Care, Inc.
• Insured Health Care Company
• Integrity Business Management, LLC (Integrity Health Medical Group)
• Laurel Ip
• Carlos Manuel Irizar
• Ivy Medical Transport LLC
• J & L Non Emergency Medical Transportation LLC
• J & S Homecare Providers, LLC
• Aredila Shonte Jackson
• Bambi Jackson, MSW

• Clinic/Center in Duluth, GA
• Providers in Duluth, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.