Organization Active NPI

National Healthcare Center LLC

  • Internal Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1932563640
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37708 Issued in GA
Legal business name
NATIONAL HEALTHCARE CENTER LLC
Practice address
135 Eagles Walk Ste 100
Stockbridge, GA 30281-7205
Phone
(770) 318-0476
NPI assigned
Apr 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Authorized official

Name
Averil Johnson
Title
Manager
Phone
(770) 318-0476

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 38817 GA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 37708 GA Primary

Addresses

Primary practice location

135 Eagles Walk Ste 100
Stockbridge, GA 30281-7205

Mailing address

950 Herrington Rd Ste C64
Lawrenceville, GA 30044-7217
Phone (770) 318-0476

Other practice location 1

759 Martin Luther King Jr Dr NW Ste 300
Atlanta, GA 30314-4193
Phone (770) 318-0476

National Provider Directory

National Provider Directory

Locations

759 Martin Luther King Jr Dr NW
Ste 300
Atlanta, GA 30314
Phone (770) 318-0476

759 Mlk Jr Dr NW
Atlanta, GA 30314
Phone (404) 588-0464

950 Herrington Rd
Ste C64
Lawrenceville, GA 30044

3001 S Cobb Dr SE
Ste 207
Smyrna, GA 30080

280 Corporate Center Dr
Ste B
Stockbridge, GA 30281

135 Eagles Walk
Ste 100
Stockbridge, GA 30281
Phone (470) 726-4147

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1932563640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 HERRINGTON RD STE C64",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447217",
            "telephone_number": "770-318-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817205",
            "telephone_number": "770-318-0476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Martin Luther King Jr Dr NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303144193",
            "country_code": "US",
            "telephone_number": "770-318-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATIONAL HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-08",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "AVERIL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-318-0476"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "38817",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "37708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.