| Ascend Medical Georgia Ii Pc | |
|
3560 Lenox Rd Ne Ste 1230 Atlanta GA 30326-4266 | |
| (404) 947-8066 | |
| Not Available |
| Full Name | Ascend Medical Georgia Ii Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3560 Lenox Rd Ne Ste 1230, Atlanta, Georgia |
| Authorized Official Name and Position | Shannon Hernandez (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 4049988645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascend Medical Georgia Ii Pc 3560 Lenox Rd Ne Ste 1230 Atlanta GA 30326-4266 Ph: (888) 250-5708 | Ascend Medical Georgia Ii Pc 3560 Lenox Rd Ne Ste 1230 Atlanta GA 30326-4266 Ph: (404) 947-8066 |
| NPI Number | 1659966075 |
|---|---|
| Provider Enumeration Date | 03/08/2021 |
| Last Update Date | 07/15/2024 |
| Medicare PECOS PAC ID | 0547657181 |
|---|---|
| Medicare Enrollment ID | O20220428001192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659966075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sarah Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073875563 PECOS PAC ID: 2163644832 Enrollment ID: I20230714000912 |
| Provider Name | Tonya Marie Epps |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124608203 PECOS PAC ID: 4789033028 Enrollment ID: I20231212000603 |
| Provider Name | Robert L Carroll |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1336638022 PECOS PAC ID: 9830548023 Enrollment ID: I20231213002299 |
| Provider Name | Scott Bonk |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609930304 PECOS PAC ID: 2961852876 Enrollment ID: I20231219000526 |
| Provider Name | Paul Vincent Ryan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710698998 PECOS PAC ID: 1456702380 Enrollment ID: I20240104003743 |
| Provider Name | Leslie Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205991379 PECOS PAC ID: 1951793892 Enrollment ID: I20240206003901 |
| Provider Name | Marguerite Spiotta Booth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275236580 PECOS PAC ID: 5092158063 Enrollment ID: I20240206004102 |
| Provider Name | Jennifer Caruso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629310123 PECOS PAC ID: 8325483563 Enrollment ID: I20240228000804 |
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