| Laureate Medical Group At Northside Llc | |
|
1110 W Peachtree St Nw Ste 1100 Atlanta GA 30309-3609 | |
| (404) 892-2131 | |
| (404) 215-9222 |
| Full Name | Laureate Medical Group At Northside Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1110 W Peachtree St Nw Ste 1100, Atlanta, Georgia |
| Authorized Official Name and Position | Jorge J Hernandez (VP ADMIN/CCO) |
| Authorized Official Contact | 4048516378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laureate Medical Group At Northside Llc 1110 W Peachtree St Nw Ste 1100 Atlanta GA 30309-3609 Ph: (404) 892-2131 | Laureate Medical Group At Northside Llc 1110 W Peachtree St Nw Ste 1100 Atlanta GA 30309-3609 Ph: (404) 892-2131 |
| NPI Number | 1811037336 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 11/30/2018 |
| Medicare PECOS PAC ID | 2668458530 |
|---|---|
| Medicare Enrollment ID | O20040629001613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811037336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert A Mills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174629208 PECOS PAC ID: 3577458470 Enrollment ID: I20040219000235 |
| Provider Name | Scott M Leibowitz |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1184618100 PECOS PAC ID: 5991794414 Enrollment ID: I20040511000328 |
| Provider Name | Elizabeth A D'amico Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639278195 PECOS PAC ID: 5799738753 Enrollment ID: I20050302000264 |
| Provider Name | David P Williams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750355962 PECOS PAC ID: 0345283040 Enrollment ID: I20050603000431 |
| Provider Name | Frieda L Millhouse-jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144272568 PECOS PAC ID: 7810912078 Enrollment ID: I20051007000150 |
| Provider Name | Rhonda D White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922096510 PECOS PAC ID: 2365457843 Enrollment ID: I20060221000247 |
| Provider Name | Cheryl Orlansky |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104869924 PECOS PAC ID: 3678576550 Enrollment ID: I20060815000046 |
| Provider Name | Oluranti Adelek Aladesanmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891899449 PECOS PAC ID: 3870503576 Enrollment ID: I20061121000525 |
| Provider Name | Rachel M Delfavero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992982003 PECOS PAC ID: 9638240344 Enrollment ID: I20080624000006 |
| Provider Name | Rachna Relwani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760418321 PECOS PAC ID: 0345273256 Enrollment ID: I20080721000594 |
| Provider Name | Sumana G Reddy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588741888 PECOS PAC ID: 0840345799 Enrollment ID: I20090831000229 |
| Provider Name | Gavin F Brown |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710164975 PECOS PAC ID: 1355470188 Enrollment ID: I20100603000441 |
| Provider Name | Sakib S Qureshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215105051 PECOS PAC ID: 9537292784 Enrollment ID: I20100809000675 |
| Provider Name | Lisa W Lefkovits |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962560128 PECOS PAC ID: 8325162050 Enrollment ID: I20100901000265 |
| Provider Name | Adam Joseph Leaderman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407808892 PECOS PAC ID: 8426231531 Enrollment ID: I20110503000530 |
| Provider Name | Mary Anne L Valdecanas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255383667 PECOS PAC ID: 2163605262 Enrollment ID: I20110503000594 |
| Provider Name | Arnold B Mellits |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851343289 PECOS PAC ID: 1153504261 Enrollment ID: I20110504000020 |
| Provider Name | Kate S Wheeler |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639121056 PECOS PAC ID: 5890978993 Enrollment ID: I20110505000090 |
| Provider Name | Walton H Reeves |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245282623 PECOS PAC ID: 8527241629 Enrollment ID: I20110505000104 |
| Provider Name | Alan Jay Gottlieb |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1669424966 PECOS PAC ID: 4284610155 Enrollment ID: I20110505000141 |
| Provider Name | Ibrez R Bandukwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720030109 PECOS PAC ID: 4981887080 Enrollment ID: I20110505000161 |
| Provider Name | Scott B Kleber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730131194 PECOS PAC ID: 9436332533 Enrollment ID: I20110505000191 |
| Provider Name | Valerie A Wender |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700838182 PECOS PAC ID: 5799968806 Enrollment ID: I20110512000085 |
| Provider Name | Chandra S Ghosh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578515060 PECOS PAC ID: 6608059704 Enrollment ID: I20110525000014 |
| Provider Name | Mark G Friedman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467404848 PECOS PAC ID: 5799968897 Enrollment ID: I20110531000093 |
| Provider Name | Swapna Velamakanni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689835746 PECOS PAC ID: 8426223116 Enrollment ID: I20111207000807 |
| Provider Name | Melody B Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689961666 PECOS PAC ID: 2769649110 Enrollment ID: I20120213000754 |
| Provider Name | Laurie A Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023396272 PECOS PAC ID: 3274792155 Enrollment ID: I20120313000319 |
| Provider Name | Suma Dronavalli |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679525679 PECOS PAC ID: 3870495856 Enrollment ID: I20120418000801 |
| Provider Name | Jacqueline W Green |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427219609 PECOS PAC ID: 6800030487 Enrollment ID: I20130920000722 |
| Provider Name | Monica N Giles |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679738595 PECOS PAC ID: 6204085905 Enrollment ID: I20131017001402 |
| Provider Name | Jennie H Law |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1386821049 PECOS PAC ID: 4183749294 Enrollment ID: I20131209000908 |
| Provider Name | Laura Gandy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427378306 PECOS PAC ID: 2769620178 Enrollment ID: I20140214000555 |
| Provider Name | Jason Silverston |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245498609 PECOS PAC ID: 8224187844 Enrollment ID: I20150318002717 |
| Provider Name | Audrey H Nuccio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386960532 PECOS PAC ID: 5294046900 Enrollment ID: I20150623000405 |
| Provider Name | Jonathan Drori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174887616 PECOS PAC ID: 6406160795 Enrollment ID: I20150730012521 |
| Provider Name | India Kenyonda Holloway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750721668 PECOS PAC ID: 5890084610 Enrollment ID: I20160518001787 |
| Provider Name | Christian Michael Cabrera Kang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134419088 PECOS PAC ID: 7012211600 Enrollment ID: I20160518001920 |
| Provider Name | Julia Anne Bern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407236987 PECOS PAC ID: 9830488667 Enrollment ID: I20160518001987 |
| Provider Name | Stacey C Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386980837 PECOS PAC ID: 2567754476 Enrollment ID: I20160714000127 |
| Provider Name | Blair Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407227606 PECOS PAC ID: 9032404074 Enrollment ID: I20160830000579 |
| Provider Name | Lori S Lockwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942686688 PECOS PAC ID: 2567740301 Enrollment ID: I20161028000822 |
| Provider Name | Radhika Sampat |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508155854 PECOS PAC ID: 9931403136 Enrollment ID: I20161107000331 |
| Provider Name | Murad C Assaad |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1912265109 PECOS PAC ID: 7315170321 Enrollment ID: I20161219002556 |
| Provider Name | Vanessa Kiepura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124446810 PECOS PAC ID: 3476858457 Enrollment ID: I20171011002451 |
| Provider Name | Sisira Reddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1629339916 PECOS PAC ID: 1759656036 Enrollment ID: I20171012002114 |
| Provider Name | Shital Popat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447563572 PECOS PAC ID: 3678720661 Enrollment ID: I20180628002519 |
| Provider Name | Upasana Bagaria Chohan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013303148 PECOS PAC ID: 9638426182 Enrollment ID: I20180716001961 |
| Provider Name | Papita M Rozario |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1194167056 PECOS PAC ID: 7911204862 Enrollment ID: I20180817003010 |
| Provider Name | Amita H Thakkar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1841446721 PECOS PAC ID: 4385769017 Enrollment ID: I20180821000917 |
| Provider Name | John Benjamin Marshall |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568701498 PECOS PAC ID: 5294086872 Enrollment ID: I20180920001405 |
| Provider Name | Zeina Alexandra Yanbeiy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1366857211 PECOS PAC ID: 3072823376 Enrollment ID: I20190813000695 |
| Provider Name | Mary Elizabeth Hardin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073975009 PECOS PAC ID: 3375830524 Enrollment ID: I20190918003674 |
| Provider Name | Stephen D Skjei |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1518994607 PECOS PAC ID: 5799881769 Enrollment ID: I20200609002572 |
| Provider Name | Natanel Leibu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821470550 PECOS PAC ID: 0648554808 Enrollment ID: I20200703000047 |
| Provider Name | Beverly D Schuler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962799270 PECOS PAC ID: 4789808882 Enrollment ID: I20200727003540 |
| Provider Name | Sarah G French |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063857803 PECOS PAC ID: 0143462598 Enrollment ID: I20201117001586 |
| Provider Name | Scott P Leaderman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255886024 PECOS PAC ID: 0446663199 Enrollment ID: I20210119002202 |
| Provider Name | Gilberto E Delriovives |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528714953 PECOS PAC ID: 9537555032 Enrollment ID: I20220411000593 |
| Provider Name | Caridad Claiborne |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1851806756 PECOS PAC ID: 6406236207 Enrollment ID: I20220711003272 |
| Provider Name | Leah Valvano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124793864 PECOS PAC ID: 9830570191 Enrollment ID: I20220718001877 |
| Provider Name | Neeja V Desai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245650068 PECOS PAC ID: 4082914270 Enrollment ID: I20220901002143 |
| Provider Name | Kerry Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063078186 PECOS PAC ID: 9739555954 Enrollment ID: I20221013000228 |
| Provider Name | Tami Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952716136 PECOS PAC ID: 6305212002 Enrollment ID: I20221020003223 |
| Provider Name | Syed F Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093134744 PECOS PAC ID: 7618293101 Enrollment ID: I20230724000586 |
| Provider Name | Kristy Nicole Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154180925 PECOS PAC ID: 7719325315 Enrollment ID: I20240402001297 |
| Provider Name | Taylor Michelle Dixon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275276479 PECOS PAC ID: 5496194912 Enrollment ID: I20240417001362 |
Extreme Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2484 Briarcliff Rd Ne, Suite 22-353, Atlanta, GA 30329 Phone: 678-237-6363 | |
Saint Joseph's Mercy Care - Mary Hall Freedom House Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Hannover Park Rd Ste 100, Atlanta, GA 30350 Phone: 678-843-8500 Fax: 678-843-8601 | |
Physicians Care Centers Of Atlanta, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 285 Boulevard Ne, Suite 435, Atlanta, GA 30312 Phone: 561-385-0731 | |
Tis (to Inspire Strong) African Children Fund, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 Peachtree Rd Ne Ste 206a, Atlanta, GA 30309 Phone: 202-872-8333 | |
Comfort Medical Center Phoenix Blvd, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1903 Phoenix Blvd Ste 125, Atlanta, GA 30349 Phone: 404-982-4228 Fax: 404-275-0676 | |
Aylo Health, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339 Phone: 770-914-0116 Fax: 770-914-7703 | |
Cardiac Disease Specialists, Pc- Sheffield Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1938 Peachtree Rd Nw, Ste 412, Atlanta, GA 30309 Phone: 404-351-3231 Fax: 404-351-3167 |