| Gwinnett Clinic | |
|
5330 Northwater Way Duluth GA 30097-2485 | |
| (770) 840-8581 | |
| (770) 840-0641 |
| Full Name | Gwinnett Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 5330 Northwater Way, Duluth, Georgia |
| Authorized Official Name and Position | Deep Shah (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7709953300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwinnett Clinic 10600 Medlock Bridge Rd Duluth GA 30097-8404 | Gwinnett Clinic 5330 Northwater Way Duluth GA 30097-2485 Ph: (770) 840-8581 |
| NPI Number | 1629117650 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Medicare PECOS PAC ID | 9436061801 |
|---|---|
| Medicare Enrollment ID | O20031104000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629117650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 173000000X | Legal Medicine | (Georgia) | Secondary |
| Provider Name | Bradley a Ebel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053301879 PECOS PAC ID: 0840198735 Enrollment ID: I20031230000351 |
| Provider Name | Nishith H Oza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063511749 PECOS PAC ID: 7113998097 Enrollment ID: I20040804000407 |
| Provider Name | Daniela Tanase |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851340632 PECOS PAC ID: 3375511017 Enrollment ID: I20040921000742 |
| Provider Name | Richard Bernard Goodjoin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306824305 PECOS PAC ID: 0941109722 Enrollment ID: I20060202000022 |
| Provider Name | Timothy N Ozburn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508989088 PECOS PAC ID: 3173616703 Enrollment ID: I20080618000495 |
| Provider Name | Raul Edgardo Paraliticci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174575336 PECOS PAC ID: 6204731193 Enrollment ID: I20080925000426 |
| Provider Name | Byol Shin |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1669680401 PECOS PAC ID: 2769541150 Enrollment ID: I20081029000787 |
| Provider Name | Chockeo Syvanthong |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992861488 PECOS PAC ID: 8426113192 Enrollment ID: I20090212000096 |
| Provider Name | Jayendrakumar J Shah |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568411254 PECOS PAC ID: 4880587013 Enrollment ID: I20090601000331 |
| Provider Name | Alpesh Dinesh Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891769782 PECOS PAC ID: 5294746319 Enrollment ID: I20100901000731 |
| Provider Name | John Arnold |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871567743 PECOS PAC ID: 6103837224 Enrollment ID: I20100902000282 |
| Provider Name | Ho Nien Lin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790759165 PECOS PAC ID: 7012928138 Enrollment ID: I20100914000062 |
| Provider Name | Padmini Gunadeva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962451849 PECOS PAC ID: 8729266226 Enrollment ID: I20110706000101 |
| Provider Name | Hong Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396794863 PECOS PAC ID: 9830368489 Enrollment ID: I20110816000459 |
| Provider Name | Gabriel Nguena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801845680 PECOS PAC ID: 0244409894 Enrollment ID: I20110816000518 |
| Provider Name | Mailupillai Kumareswaran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487603262 PECOS PAC ID: 6204006661 Enrollment ID: I20110823000654 |
| Provider Name | Meena J Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912956707 PECOS PAC ID: 4385556760 Enrollment ID: I20110824000254 |
| Provider Name | Raja Ram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144279027 PECOS PAC ID: 3678743408 Enrollment ID: I20110902000228 |
| Provider Name | Dinesh Ven Koba Raju |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548465198 PECOS PAC ID: 4587831151 Enrollment ID: I20120123000423 |
| Provider Name | Shveta Shah Raju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376748806 PECOS PAC ID: 0840323796 Enrollment ID: I20120123000432 |
| Provider Name | Christy a Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881914984 PECOS PAC ID: 2264669274 Enrollment ID: I20131219001464 |
| Provider Name | Shomari a Ruffin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114185840 PECOS PAC ID: 0648413922 Enrollment ID: I20140729000721 |
| Provider Name | Michele Anne Chernesky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588776298 PECOS PAC ID: 6002896701 Enrollment ID: I20150223001319 |
| Provider Name | Angela Dawn Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467838334 PECOS PAC ID: 5294035457 Enrollment ID: I20151120000437 |
| Provider Name | Jessica a Etzkorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275903981 PECOS PAC ID: 8729389069 Enrollment ID: I20151210002245 |
| Provider Name | Deep Jayendrakumar Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114361458 PECOS PAC ID: 6608172770 Enrollment ID: I20160316000570 |
| Provider Name | Kayla Glenn Rosenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497296990 PECOS PAC ID: 5496032930 Enrollment ID: I20170510000855 |
| Provider Name | Shanon Dail Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174664163 PECOS PAC ID: 4789632159 Enrollment ID: I20190208002896 |
| Provider Name | Rachel Pocock Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457892770 PECOS PAC ID: 1759651516 Enrollment ID: I20200723003736 |
| Provider Name | Caitlin Wheeler Suilmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497118178 PECOS PAC ID: 4981997053 Enrollment ID: I20210610003448 |
| Provider Name | Jincy Mathew Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629568720 PECOS PAC ID: 0941606792 Enrollment ID: I20210902002470 |
| Provider Name | Anup Jagdish Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720541931 PECOS PAC ID: 0547595159 Enrollment ID: I20220714001625 |
| Provider Name | Jamie Allison Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417608258 PECOS PAC ID: 8820461676 Enrollment ID: I20230227002063 |
| Provider Name | Daisy Kwende |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568099208 PECOS PAC ID: 9234551417 Enrollment ID: I20230828003465 |
| Provider Name | Karrie Garcia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225751142 PECOS PAC ID: 6608215439 Enrollment ID: I20240412002947 |
| Provider Name | Malnie Ally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548928021 PECOS PAC ID: 3375984834 Enrollment ID: I20240515000594 |
| Provider Name | Toniann Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972899714 PECOS PAC ID: 1254559644 Enrollment ID: I20240618000335 |
| Provider Name | Jatayah Nicole Sheed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093391997 PECOS PAC ID: 6103226782 Enrollment ID: I20240725003836 |
| Provider Name | Arnaud Pierre Felix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750352514 PECOS PAC ID: 0840191367 Enrollment ID: I20241220000128 |
| Provider Name | George Michael Spencer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184604068 PECOS PAC ID: 3870507114 Enrollment ID: I20250331001308 |
| Provider Name | Vafa Mansour Sobhani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881261394 PECOS PAC ID: 8123421369 Enrollment ID: I20250403000488 |
| Provider Name | Caitlin Leverenz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245015098 PECOS PAC ID: 9032622915 Enrollment ID: I20250702003860 |
| Provider Name | Shayla Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609631183 PECOS PAC ID: 8325554322 Enrollment ID: I20250717002966 |
| Provider Name | Jenny Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538054747 PECOS PAC ID: 1456867498 Enrollment ID: I20250717003923 |
| Provider Name | Marissa Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447040217 PECOS PAC ID: 5395241772 Enrollment ID: I20251003002417 |
| Provider Name | Keith Nesta Walters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174264907 PECOS PAC ID: 5092196774 Enrollment ID: I20251007000473 |
| Provider Name | So Mee Kwon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487509766 PECOS PAC ID: 4880179811 Enrollment ID: I20260327002514 |
Leslie Gaskill, MD, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6290 Abbotts Bridge Rd, Suite 201, Duluth, GA 30097 Phone: 770-495-9995 Fax: 770-232-1999 |
Anapa Wellness and Chiropractic Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2472 Pleasant Hill Rd, Suite 203a, Duluth, GA 30096 Phone: 770-623-9229 Fax: 866-868-8705 |
Express Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3350 Steve Reynolds Blvd, Ste 408, Duluth, GA 30096 Phone: 678-783-4449 |
Modern Family Medicine, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3460 Summit Ridge Pkwy Ste 304, Duluth, GA 30096 Phone: 770-771-5115 Fax: 770-771-5116 |
Proactive Medical Center LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3455 Peachtree Industrial Blvd Ste 910, Duluth, GA 30096 Phone: 678-584-5000 |
Benchmark Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3790 Pleasant Hill Rd Ste 100, Duluth, GA 30096 Phone: 770-497-4228 Fax: 770-497-4474 |