| Excelsis Health Llc | |
|
711 Canton Rd Ne Ste 420 Marietta GA 30060-8949 | |
| (678) 392-3548 | |
| (833) 992-2064 |
| Full Name | Excelsis Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 711 Canton Rd Ne Ste 420, Marietta, Georgia |
| Authorized Official Name and Position | Angelina Cain (OWNER) |
| Authorized Official Contact | 7063923548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excelsis Health Llc 711 Canton Rd Ne Ste 420 Marietta GA 30060-8949 Ph: (678) 392-3548 | Excelsis Health Llc 711 Canton Rd Ne Ste 420 Marietta GA 30060-8949 Ph: (678) 392-3548 |
| NPI Number | 1770247736 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 10/27/2021 |
| Medicare PECOS PAC ID | 8123416690 |
|---|---|
| Medicare Enrollment ID | O20211102003113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770247736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | (* (Not Available)) | Primary |
| Provider Name | Angelina F Cain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356543557 PECOS PAC ID: 4587734306 Enrollment ID: I20140324001462 |
| Provider Name | Shea Elizabeth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235728353 PECOS PAC ID: 6507274800 Enrollment ID: I20210427001454 |
| Provider Name | Allison Wade Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700462801 PECOS PAC ID: 6608314877 Enrollment ID: I20240819003838 |
| Provider Name | Justin Chandler Casano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750034682 PECOS PAC ID: 2567901291 Enrollment ID: I20240827000523 |
| Provider Name | Michele L Turpin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275239055 PECOS PAC ID: 2961935754 Enrollment ID: I20241031003923 |
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