| Georgia Palliative Care Services Llc | |
|
2849 Paces Ferry Rd Se Ste 380 Atlanta GA 30339-3769 | |
| (470) 737-0300 | |
| (801) 883-8044 |
| Full Name | Georgia Palliative Care Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2849 Paces Ferry Rd Se Ste 380, Atlanta, Georgia |
| Authorized Official Name and Position | Mark L Phillips (NATIONAL DIRECTOR OF PHYSICIAN SER.) |
| Authorized Official Contact | 8019244992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Palliative Care Services Llc 206 N 2100 W Ste 202 Salt Lake City UT 84116-4741 Ph: (801) 924-8571 | Georgia Palliative Care Services Llc 2849 Paces Ferry Rd Se Ste 380 Atlanta GA 30339-3769 Ph: (470) 737-0300 |
| NPI Number | 1295290450 |
|---|---|
| Provider Enumeration Date | 02/01/2019 |
| Last Update Date | 03/25/2019 |
| Medicare PECOS PAC ID | 9537492137 |
|---|---|
| Medicare Enrollment ID | O20190613002834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295290450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard Abrohams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497831390 PECOS PAC ID: 1759417355 Enrollment ID: I20100408000226 |
| Provider Name | Carol Marsden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144567025 PECOS PAC ID: 8123390242 Enrollment ID: I20170823003380 |
| Provider Name | Anna K Sikod |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811316995 PECOS PAC ID: 7113229428 Enrollment ID: I20170920002566 |
| Provider Name | Angella Dinina Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649729799 PECOS PAC ID: 7517141286 Enrollment ID: I20180524002367 |
| Provider Name | Terri M Clack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487169173 PECOS PAC ID: 0143579086 Enrollment ID: I20180825000126 |
| Provider Name | Clara M Teter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902371644 PECOS PAC ID: 8325388903 Enrollment ID: I20190318001854 |
| Provider Name | Marvet Wint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386036895 PECOS PAC ID: 1254664865 Enrollment ID: I20190613002902 |
| Provider Name | Laura Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265906226 PECOS PAC ID: 0941534366 Enrollment ID: I20190618003806 |
| Provider Name | Shena Ogletree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457821373 PECOS PAC ID: 7719318617 Enrollment ID: I20200508001993 |
| Provider Name | Aleena G Herrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316409451 PECOS PAC ID: 1456773894 Enrollment ID: I20200612000670 |
| Provider Name | Ashley Mose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801333281 PECOS PAC ID: 5597049635 Enrollment ID: I20200827000316 |
| Provider Name | Audrey Russo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689185357 PECOS PAC ID: 9436537842 Enrollment ID: I20220525001818 |
| Provider Name | Rekiyat O Subair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619567575 PECOS PAC ID: 3173903614 Enrollment ID: I20220630001485 |
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