| Georgia Highlands Medical Services, Inc. | |
|
260 Elm St Cumming GA 30040-2467 | |
| (770) 887-1668 | |
| (770) 781-9937 |
| Full Name | Georgia Highlands Medical Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 260 Elm St, Cumming, Georgia |
| Authorized Official Name and Position | Todd Shifflet (CEO) |
| Authorized Official Contact | 7708871668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Highlands Medical Services, Inc. Po Box 307 Cumming GA 30028-0307 Ph: (770) 887-1668 | Georgia Highlands Medical Services, Inc. 260 Elm St Cumming GA 30040-2467 Ph: (770) 887-1668 |
| NPI Number | 1174529192 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5890682017 |
|---|---|
| Medicare Enrollment ID | O20040302001307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174529192 | NPI | - | NPPES |
| 000192574C | Medicaid | GA | |
| 300022400A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Georgia) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Swapna Madhavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205880309 PECOS PAC ID: 1557373958 Enrollment ID: I20060630000073 |
| Provider Name | Heather S Hardison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801085790 PECOS PAC ID: 3678654779 Enrollment ID: I20080115000393 |
| Provider Name | Alice J Philip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497932040 PECOS PAC ID: 2961560768 Enrollment ID: I20081023000281 |
| Provider Name | Angela Y Bolger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134318702 PECOS PAC ID: 1052458395 Enrollment ID: I20091020000136 |
| Provider Name | Lee H Battle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487621033 PECOS PAC ID: 7315139714 Enrollment ID: I20101004000939 |
| Provider Name | Nandor Alfonso Kalli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134197502 PECOS PAC ID: 4486683539 Enrollment ID: I20120921000348 |
| Provider Name | Deena Maria Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750657961 PECOS PAC ID: 7214185982 Enrollment ID: I20120921000383 |
| Provider Name | Lori Ann Waters Millsap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548297146 PECOS PAC ID: 8527071968 Enrollment ID: I20121207000168 |
| Provider Name | Cynthia J Rinehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356481873 PECOS PAC ID: 4385823889 Enrollment ID: I20130219000378 |
| Provider Name | Paola Suarez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326221698 PECOS PAC ID: 0042397937 Enrollment ID: I20130403000300 |
| Provider Name | Amy Danielle Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235478025 PECOS PAC ID: 6204072689 Enrollment ID: I20130410000358 |
| Provider Name | Ashley Ford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881022309 PECOS PAC ID: 3678700580 Enrollment ID: I20131223001051 |
| Provider Name | William Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811166705 PECOS PAC ID: 6406983279 Enrollment ID: I20160822001175 |
| Provider Name | Russell George Remalia |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1710073507 PECOS PAC ID: 0941245443 Enrollment ID: I20161012001811 |
| Provider Name | Nazia Moiz Younus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922552124 PECOS PAC ID: 0547558231 Enrollment ID: I20161012002254 |
| Provider Name | Pragya Verma Bhatnagar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528231321 PECOS PAC ID: 1951683598 Enrollment ID: I20170117000315 |
| Provider Name | Amanda Gabriella Mor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801398227 PECOS PAC ID: 9931455912 Enrollment ID: I20180705001092 |
| Provider Name | Angela Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407412042 PECOS PAC ID: 7911233044 Enrollment ID: I20190729000560 |
| Provider Name | Katrina M Mansmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447793344 PECOS PAC ID: 5597046540 Enrollment ID: I20190930001696 |
| Provider Name | James Michael Holliday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962032375 PECOS PAC ID: 3678995834 Enrollment ID: I20200617002406 |
| Provider Name | Rhonda L Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295351294 PECOS PAC ID: 7315358140 Enrollment ID: I20201130000299 |
| Provider Name | Angelica Maria Larios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912361288 PECOS PAC ID: 8426461104 Enrollment ID: I20210120000331 |
| Provider Name | Kim Guastella |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013152784 PECOS PAC ID: 2961569850 Enrollment ID: I20210204001693 |
| Provider Name | Hilda B Grindell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780136796 PECOS PAC ID: 5395152474 Enrollment ID: I20210408000843 |
| Provider Name | Hailey Gatins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578148292 PECOS PAC ID: 9436567526 Enrollment ID: I20210408001475 |
| Provider Name | Millie Brabham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760076046 PECOS PAC ID: 1456755164 Enrollment ID: I20210803001184 |
| Provider Name | Linda Kuzhippala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053725408 PECOS PAC ID: 9032471677 Enrollment ID: I20220126000642 |
| Provider Name | Paulina Huynh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477107142 PECOS PAC ID: 4486042801 Enrollment ID: I20220127000220 |
| Provider Name | Sarah Gasperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295487379 PECOS PAC ID: 6608269626 Enrollment ID: I20220215000515 |
| Provider Name | Jessie Friedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902559651 PECOS PAC ID: 1951795640 Enrollment ID: I20220223000148 |
| Provider Name | Abigail Wilwant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457003832 PECOS PAC ID: 8224422373 Enrollment ID: I20220307000818 |
| Provider Name | Erin Shea Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033785431 PECOS PAC ID: 3274911375 Enrollment ID: I20220601002690 |
| Provider Name | Crystal A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659317675 PECOS PAC ID: 6103008701 Enrollment ID: I20220614001590 |
| Provider Name | Angel Enwemadu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316661002 PECOS PAC ID: 2062611866 Enrollment ID: I20221020001403 |
| Provider Name | Milan Johnson Johnson Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174024780 PECOS PAC ID: 5890169205 Enrollment ID: I20230327002191 |
| Provider Name | Erin Marie Bardonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952016396 PECOS PAC ID: 5193190320 Enrollment ID: I20230331000765 |
| Provider Name | Willie Gilbert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861804205 PECOS PAC ID: 8123352143 Enrollment ID: I20230725000690 |
| Provider Name | Maryana Kleyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669049169 PECOS PAC ID: 1355792748 Enrollment ID: I20240110002455 |
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