| Northeast Georgia Diagnostic Associates And Clinic, Llc | |
|
1240 Jesse Jewell Pkwy Se Ste 500 Gainesville GA 30501-3861 | |
| (855) 709-4535 | |
| Not Available |
| Full Name | Northeast Georgia Diagnostic Associates And Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, Georgia |
| Authorized Official Name and Position | Jorge J Hernandez (VP ADMIN SRVS./CCO) |
| Authorized Official Contact | 4048516378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Georgia Diagnostic Associates And Clinic, Llc 1100 Johnson Fy Rd Ne Ste 780 Atlanta GA 30342-1743 Ph: () - | Northeast Georgia Diagnostic Associates And Clinic, Llc 1240 Jesse Jewell Pkwy Se Ste 500 Gainesville GA 30501-3861 Ph: (855) 709-4535 |
| NPI Number | 1144719311 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 1951655737 |
|---|---|
| Medicare Enrollment ID | O20181114000949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144719311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Mark D Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285631887 PECOS PAC ID: 2961479324 Enrollment ID: I20040914001333 |
| Provider Name | Gregory L Mauldin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871673749 PECOS PAC ID: 2668430612 Enrollment ID: I20050209000622 |
| Provider Name | Douglas A Isenstein |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528148400 PECOS PAC ID: 7618928409 Enrollment ID: I20050209000654 |
| Provider Name | Patricia A Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447285176 PECOS PAC ID: 3971558529 Enrollment ID: I20050316000384 |
| Provider Name | Wesley D Head |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1487657508 PECOS PAC ID: 4587611207 Enrollment ID: I20050405000939 |
| Provider Name | Andre M Kallab |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1669475760 PECOS PAC ID: 0244272383 Enrollment ID: I20050527000704 |
| Provider Name | Joseph E West |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043375025 PECOS PAC ID: 5294770913 Enrollment ID: I20050623000165 |
| Provider Name | Christopher S Bussler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609879881 PECOS PAC ID: 7012943061 Enrollment ID: I20050712000472 |
| Provider Name | Amsel M Siore |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013097971 PECOS PAC ID: 9537196308 Enrollment ID: I20050722000774 |
| Provider Name | Cacia Soares Welch |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295738151 PECOS PAC ID: 8527098607 Enrollment ID: I20050818000193 |
| Provider Name | Matthey T Harris |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1043213176 PECOS PAC ID: 4284664137 Enrollment ID: I20050819000480 |
| Provider Name | Mini J Shivprasad |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1407836158 PECOS PAC ID: 8325074834 Enrollment ID: I20060323000691 |
| Provider Name | Tracy L Lovell |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1821066952 PECOS PAC ID: 5092727495 Enrollment ID: I20060630000079 |
| Provider Name | Saloni H Tanna |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1760422117 PECOS PAC ID: 0749293835 Enrollment ID: I20060712000239 |
| Provider Name | Theron E Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699817098 PECOS PAC ID: 6507960093 Enrollment ID: I20070322000095 |
| Provider Name | Sylvia T Dold |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326088873 PECOS PAC ID: 7416969936 Enrollment ID: I20070511000340 |
| Provider Name | Terri P Kemmerer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013199587 PECOS PAC ID: 2860570405 Enrollment ID: I20080422000600 |
| Provider Name | Padma C Nadella |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548375660 PECOS PAC ID: 7113096603 Enrollment ID: I20080523000491 |
| Provider Name | Paul H Chenard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174796874 PECOS PAC ID: 3971540824 Enrollment ID: I20080530000152 |
| Provider Name | Alok Sachdeva |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1750504262 PECOS PAC ID: 4183795156 Enrollment ID: I20080618000586 |
| Provider Name | Mark Kats |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215140355 PECOS PAC ID: 5496822736 Enrollment ID: I20080929000165 |
| Provider Name | Christina A Saurel |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1104025154 PECOS PAC ID: 3971697442 Enrollment ID: I20080929000272 |
| Provider Name | Brian J Wechter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760639207 PECOS PAC ID: 2961561931 Enrollment ID: I20081105000445 |
| Provider Name | Brent J Archer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073702916 PECOS PAC ID: 9133271851 Enrollment ID: I20090710000132 |
| Provider Name | Craig M Brown |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063680882 PECOS PAC ID: 2769534239 Enrollment ID: I20090714000402 |
| Provider Name | Hanna A Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831100866 PECOS PAC ID: 1951441328 Enrollment ID: I20091215000517 |
| Provider Name | Richard J Gomez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316940554 PECOS PAC ID: 8426065103 Enrollment ID: I20100119000081 |
| Provider Name | Sean M Sumner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093718942 PECOS PAC ID: 4587706700 Enrollment ID: I20100126000272 |
| Provider Name | Jeffrey C Terry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124021761 PECOS PAC ID: 4789726977 Enrollment ID: I20100127000021 |
| Provider Name | Ralf G Augenstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902891732 PECOS PAC ID: 6901941418 Enrollment ID: I20100309000475 |
| Provider Name | Laura Anne Shepherd |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730162926 PECOS PAC ID: 6204968969 Enrollment ID: I20100715000190 |
| Provider Name | Hillary S Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851400022 PECOS PAC ID: 7315945482 Enrollment ID: I20100803000255 |
| Provider Name | Amy Roark |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699771311 PECOS PAC ID: 8022132935 Enrollment ID: I20100830000670 |
| Provider Name | Roberto M Villanueva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033112958 PECOS PAC ID: 7618091497 Enrollment ID: I20100831000545 |
| Provider Name | Eniki A Mack |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1730307927 PECOS PAC ID: 3870679822 Enrollment ID: I20100910000051 |
| Provider Name | Jennifer M John |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1447343140 PECOS PAC ID: 0648375642 Enrollment ID: I20101027000218 |
| Provider Name | Birju B Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093771347 PECOS PAC ID: 7911181862 Enrollment ID: I20110418000613 |
| Provider Name | Madhurima Adulla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073523247 PECOS PAC ID: 6002820743 Enrollment ID: I20110520000292 |
| Provider Name | Rupesh K Dave |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255525663 PECOS PAC ID: 3870629959 Enrollment ID: I20110726000157 |
| Provider Name | Richard E Blatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699951871 PECOS PAC ID: 3678740230 Enrollment ID: I20120123000300 |
| Provider Name | Kim T Tran |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972710465 PECOS PAC ID: 1951557107 Enrollment ID: I20120803000584 |
| Provider Name | Deborah Schulte Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598712713 PECOS PAC ID: 3678712353 Enrollment ID: I20130611000267 |
| Provider Name | Laura Elizabeth Vanhook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669811410 PECOS PAC ID: 7911140249 Enrollment ID: I20130905000222 |
| Provider Name | Robert Scott Barrett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780902411 PECOS PAC ID: 8921233370 Enrollment ID: I20131021001199 |
| Provider Name | Patricia Luree Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407823370 PECOS PAC ID: 8820189947 Enrollment ID: I20140414000197 |
| Provider Name | Kelly Alexis Steely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730449141 PECOS PAC ID: 2163679424 Enrollment ID: I20150618002592 |
| Provider Name | Ryan M Nadelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407110703 PECOS PAC ID: 2769630284 Enrollment ID: I20150707001244 |
| Provider Name | Betsy S Mitcham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417387382 PECOS PAC ID: 0547575128 Enrollment ID: I20151104000361 |
| Provider Name | Esther Y Lee |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1518176007 PECOS PAC ID: 8224180880 Enrollment ID: I20160808000565 |
| Provider Name | Lauren Darnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780128272 PECOS PAC ID: 3476835547 Enrollment ID: I20170125001005 |
| Provider Name | Azeem A. Mohammed |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1124258843 PECOS PAC ID: 3476787029 Enrollment ID: I20170815001740 |
| Provider Name | Melissa Summerlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043519671 PECOS PAC ID: 7810253127 Enrollment ID: I20171101003438 |
| Provider Name | Anusha Ramadhas |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1932506599 PECOS PAC ID: 2860780269 Enrollment ID: I20180806001685 |
| Provider Name | Sreedevi Veluvarti Avdhani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1235490780 PECOS PAC ID: 3577885102 Enrollment ID: I20181011000976 |
| Provider Name | Deep Shikha |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356634265 PECOS PAC ID: 4688981921 Enrollment ID: I20190730004045 |
| Provider Name | Santhi P Chennareddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568413060 PECOS PAC ID: 2264456185 Enrollment ID: I20191023003728 |
| Provider Name | Jennifer Ifeoma Obi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033472261 PECOS PAC ID: 6002249232 Enrollment ID: I20191202002563 |
| Provider Name | Vivek Sunny Sambhara |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093005852 PECOS PAC ID: 6608008941 Enrollment ID: I20200601001873 |
| Provider Name | Lucy Greer Sorto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366056764 PECOS PAC ID: 6305258377 Enrollment ID: I20201216000181 |
| Provider Name | Phaedra Alisha Hill-lazenby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346880739 PECOS PAC ID: 1658709803 Enrollment ID: I20210124000040 |
| Provider Name | Fahad Khan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1497174494 PECOS PAC ID: 3971803677 Enrollment ID: I20210804000594 |
| Provider Name | Ramapriya Sinnakirouchenan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1306077300 PECOS PAC ID: 6002030798 Enrollment ID: I20210908002400 |
| Provider Name | Antony Charles |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467435222 PECOS PAC ID: 9830161322 Enrollment ID: I20210924000000 |
| Provider Name | Yeohan Song |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1003279571 PECOS PAC ID: 7911297387 Enrollment ID: I20230626001728 |
| Provider Name | Yashswee Kc |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1093202343 PECOS PAC ID: 3577923127 Enrollment ID: I20230714001734 |
| Provider Name | Shelley Charmaine Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003363201 PECOS PAC ID: 4981984309 Enrollment ID: I20230822000724 |
| Provider Name | Rosemary Nkuna Chofor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750918009 PECOS PAC ID: 5496178931 Enrollment ID: I20230925002236 |
| Provider Name | Uthpala Munasinghe |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538574850 PECOS PAC ID: 7719251032 Enrollment ID: I20231026001377 |
| Provider Name | Justin Pandoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659755361 PECOS PAC ID: 1052614534 Enrollment ID: I20231120001056 |
| Provider Name | Megan Ann Tierney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679061840 PECOS PAC ID: 4587917562 Enrollment ID: I20231205000237 |
William T. Jones, M.d.,pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1098 S Enota Dr Ne, Gainesville, GA 30501 Phone: 770-532-4517 Fax: 770-503-0267 | |
Dr Johnny J Di Blasi Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Washington Ave, Gainesville, GA 30501 Phone: 904-482-9673 | |
Primary Care Clinics Of Georgia Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1240 Jesse Jewell Pkwy Se, Suite 370, Gainesville, GA 30501 Phone: 770-536-1004 Fax: 770-536-0905 | |
Hall County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1290 Athens St, Gainesville, GA 30507 Phone: 770-532-5344 | |
Gastroenterology Associates Of Gainesville, P. C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2324 Limestone Overlook, Gainesville, GA 30501 Phone: 770-536-8109 Fax: 770-536-3203 | |
Annual Wellness Centers Of America Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3030 Mcever Rd, Suite 300, Gainesville, GA 30504 Phone: 770-503-0021 | |
Ortho Sport & Spine Gainesville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1990 Limestone Cir, Gainesville, GA 30501 Phone: 678-752-7246 |