| Alpha Family Medicine Inc | |
|
480 N Main St Ste 202 Alpharetta GA 30009-8386 | |
| (678) 619-1974 | |
| (678) 619-1975 |
| Full Name | Alpha Family Medicine Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 480 N Main St Ste 202, Alpharetta, Georgia |
| Authorized Official Name and Position | Shyla Reddy (OWNER) |
| Authorized Official Contact | 2514593233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Family Medicine Inc Po Box 1385 Alpharetta GA 30009-1385 Ph: (678) 619-1974 | Alpha Family Medicine Inc 480 N Main St Ste 202 Alpharetta GA 30009-8386 Ph: (678) 619-1974 |
| NPI Number | 1205243458 |
|---|---|
| Provider Enumeration Date | 07/21/2014 |
| Last Update Date | 07/21/2014 |
| Medicare PECOS PAC ID | 0345469797 |
|---|---|
| Medicare Enrollment ID | O20140916002800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205243458 | NPI | - | NPPES |
| 051518001 | Other | MEDICARE PROVIDER NUMBER | |
| 009932265 | Medicaid | AL | |
| 1295774305 | Other | PERSONAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 71622 (Georgia) | Primary |
| Provider Name | Vijayalakshmi Vaddireddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629278866 PECOS PAC ID: 4385720614 Enrollment ID: I20111103000603 |
| Provider Name | Shyla Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295774305 PECOS PAC ID: 9032248356 Enrollment ID: I20140916002827 |
| Provider Name | Mildred Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568486298 PECOS PAC ID: 8325029036 Enrollment ID: I20160426001369 |
| Provider Name | Barivure Barisi Monkpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689185167 PECOS PAC ID: 1254681034 Enrollment ID: I20180829002861 |
| Provider Name | Regina D Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386126290 PECOS PAC ID: 5294076352 Enrollment ID: I20190418000755 |
| Provider Name | Kimberly Annette Eubanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093303042 PECOS PAC ID: 7416361159 Enrollment ID: I20210120003416 |
| Provider Name | Jasmine Thao Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851091342 PECOS PAC ID: 7315304334 Enrollment ID: I20230607001270 |
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