South Fulton Medical Center Practice Plan, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SOUTH FULTON MEDICAL CENTER PRACTICE PLAN, LLC

Practice address

1170 Cleveland Ave
East Point, GA 30344-3615

Phone

(404) 466-1320

Fax

(404) 466-1360

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Kyle Burtnett

Title

SVP of Outpatient Services, Tenet

Phone

(469) 893-2153

Specialties & licenses 1

Addresses

Other names 1

• South Fulton Medical Center Practice Plan Doing business as

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1972644672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615",
            "telephone_number": "404-466-1320",
            "fax_number": "404-466-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615",
            "telephone_number": "404-466-1320",
            "fax_number": "404-466-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FULTON MEDICAL CENTER PRACTICE PLAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "BURTNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "SVP OF OUTPATIENT SERVICES, TENET",
        "authorized_official_telephone_number": "469-893-2153",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Fulton Medical Center Practice Plan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Atlanta Medical Associates PC
• South Atlanta Medical Associates, PC
• South Atlanta Pulmonary Group
• South Atlanta Spine and Wellness Center
• South Fulton Dermatology Associates,LLP
• South Fulton Primary Care, LLC
• South Fulton Regional Medical Center Pro Fee Billing, LLC
• South Mental Health
• Southcare Physicians Group Surgical Specialists, LLC
• Southern International Living, Inc

• Surgery Physician in East Point, GA
• Providers in East Point, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.