Northside Primary Care Professional Services,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC

Practice address

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Phone

(855) 709-4535

NPI assigned

Apr 5, 2011

Last updated

May 18, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHSIDE HOSPITAL, INCAs reported in NPPES

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

Authorized official

Name

Amy E Fouts

Title

Chief Compliance Officer

Phone

(404) 851-6968

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715

  O20111123000206

  Same enrollment

Tax ID family

Northside Primary Care Professional Servicesllc2 organizations share this tax ID, including this one

Part of

Northsidedunwoody Surg

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Northside Hospital, Inc.

  dba Diagnostic Clinic Oncology Pharmacy

  • Community/Retail Pharmacy
  • Gainesville, GA
  • NPI 1326679150

  Member Of

  NPD member

Locations (25 of 71)

Practitioners 627

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.

• Ashley M Abbott, MD

  • Rheumatology Physician
  • Woodstock, GA
  • NPI 1528521648
  Medicare reassignment Care Compare group NPD
• Lindsey Michelle Abreu, FNP-C

  • Family Nurse Practitioner
  • Dahlonega, GA
  • NPI 1003576539
  Medicare reassignment Care Compare group NPD
• Grace Elena Acero-Smith, MSN FNP-BC

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1528582061
  Medicare reassignment Care Compare group NPD
• Lidia F Acosta Organista

  • Acute Care Nurse Practitioner
  • Atlanta, GA
  • NPI 1457242893
  Medicare reassignment Care Compare group NPD
• Samuel F Adams, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1972512069
  Medicare reassignment Care Compare group NPD
• Olanrewaju Agbe-Davies, MD

  • Vascular Neurology Physician
  • Gainesville, GA
  • NPI 1639431059
  Medicare reassignment Care Compare group NPD
• Elfriede A Agyemang, MD

  • Infectious Disease Physician
  • Atlanta, GA
  • NPI 1841511581
  Medicare reassignment Care Compare group NPD
• Rita Alema-Mensah

  • Family Nurse Practitioner
  • Lithonia, GA
  • NPI 1659871663

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Anthony Joseph Alfano, DO

  • Family Medicine Physician
  • Acworth, GA
  • NPI 1073945796
  Medicare reassignment Care Compare group NPD
• Birmaji Ali, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Canton, GA
  • NPI 1710419254
  Medicare reassignment Care Compare group NPD
• Mirza Haider Ali, M.D.

  • Pulmonary Disease Physician
  • Atlanta, GA
  • NPI 1467878777
  Medicare reassignment Care Compare group NPD
• Nasima Ali, MD

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1134237803

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1922397553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "855-709-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHSIDE HOSPITAL, INC",
        "enumeration_date": "2011-04-05",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "FOUTS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-851-6968"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "193400000X",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct",
            "address_2": "Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Northside Oral Surgery Center LLC
• Northside Orthopedic Professional Services LLC
• Northside Pediatric Orthopaedic Professional Services, LLC
• Northside Pediatrics & Adolescent Medicine PC
• Northside Podiatry, PC
• Northside Radiation Oncology PC
• Northside Radiology Associates LLC
• Northside Respiratory Care
• Northside Sepc Professional Services, LLC
• Northside Surgery Center, Inc

• Family Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.