| Medcura Health, Inc. | |
|
5582 Memorial Dr Stone Mountain GA 30083-3215 | |
| (404) 298-8998 | |
| (404) 298-7658 |
| Full Name | Medcura Health, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5582 Memorial Dr, Stone Mountain, Georgia |
| Authorized Official Name and Position | Jeffery Q Taylor (CEO) |
| Authorized Official Contact | 4042988998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medcura Health, Inc. 5582 Memorial Dr Stone Mountain GA 30083-3215 Ph: (404) 298-8998 | Medcura Health, Inc. 5582 Memorial Dr Stone Mountain GA 30083-3215 Ph: (404) 298-8998 |
| NPI Number | 1417011487 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 06/05/2021 |
| Medicare PECOS PAC ID | 2961443643 |
|---|---|
| Medicare Enrollment ID | O20120509000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417011487 | NPI | - | NPPES |
| 000446388A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Hugh Lee Durham |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669542023 PECOS PAC ID: 9234026634 Enrollment ID: I20040301001105 |
| Provider Name | Sonya D Marks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336361989 PECOS PAC ID: 4587654496 Enrollment ID: I20040513000904 |
| Provider Name | Victoria Barnes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346269172 PECOS PAC ID: 0143293878 Enrollment ID: I20040819000491 |
| Provider Name | Luther Burse |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366441438 PECOS PAC ID: 0547223406 Enrollment ID: I20041111000039 |
| Provider Name | Cherise M James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881689271 PECOS PAC ID: 0840256129 Enrollment ID: I20041208000568 |
| Provider Name | Ann E Hoos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417965062 PECOS PAC ID: 3072559251 Enrollment ID: I20050629000047 |
| Provider Name | Richard Mersberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336198969 PECOS PAC ID: 1759310956 Enrollment ID: I20050808001140 |
| Provider Name | Shalini Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245339514 PECOS PAC ID: 7517997497 Enrollment ID: I20050819000742 |
| Provider Name | Edward L Aikens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780780593 PECOS PAC ID: 5294768594 Enrollment ID: I20050916000510 |
| Provider Name | Theresa R Jacobs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013978105 PECOS PAC ID: 7810910577 Enrollment ID: I20060109000370 |
| Provider Name | Michael E Brown |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649286782 PECOS PAC ID: 6103865019 Enrollment ID: I20060320000445 |
| Provider Name | Keith Thompson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245248590 PECOS PAC ID: 1951385046 Enrollment ID: I20060921000095 |
| Provider Name | Sivanaga M Atluri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871502625 PECOS PAC ID: 0941207401 Enrollment ID: I20061026000361 |
| Provider Name | Corliss L Austin-harris |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285656181 PECOS PAC ID: 4587768866 Enrollment ID: I20070326000411 |
| Provider Name | Andrea Neita |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578778387 PECOS PAC ID: 7012016397 Enrollment ID: I20070627000470 |
| Provider Name | Maria L Lemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639376379 PECOS PAC ID: 3173624525 Enrollment ID: I20070730000098 |
| Provider Name | Mark G Hebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831268630 PECOS PAC ID: 3173605839 Enrollment ID: I20080204000091 |
| Provider Name | Charlene Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730206269 PECOS PAC ID: 4688758089 Enrollment ID: I20080225000148 |
| Provider Name | Laura L Redden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013998871 PECOS PAC ID: 4486669991 Enrollment ID: I20080603000723 |
| Provider Name | Virna L Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912163684 PECOS PAC ID: 0143396150 Enrollment ID: I20080827000346 |
| Provider Name | Jamil Ayanna Harp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619149515 PECOS PAC ID: 4082774070 Enrollment ID: I20081120000563 |
| Provider Name | Lathan Overstreet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568521052 PECOS PAC ID: 8224936661 Enrollment ID: I20081216000614 |
| Provider Name | Janella L Thomas Burse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164469193 PECOS PAC ID: 5496751737 Enrollment ID: I20090716000724 |
| Provider Name | Zenobia L Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831362748 PECOS PAC ID: 0244382430 Enrollment ID: I20090720000203 |
| Provider Name | David A Stahura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801885934 PECOS PAC ID: 6608879465 Enrollment ID: I20090814000141 |
| Provider Name | Quintin R Robinson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760684658 PECOS PAC ID: 7315063765 Enrollment ID: I20100923000369 |
| Provider Name | John M Maloney |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255366456 PECOS PAC ID: 0446235634 Enrollment ID: I20101207000527 |
| Provider Name | Tracey Greene-johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477571081 PECOS PAC ID: 4880600451 Enrollment ID: I20101222000531 |
| Provider Name | Shalandra R Ross |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215109137 PECOS PAC ID: 5092995738 Enrollment ID: I20110211000634 |
| Provider Name | Joan T James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801041595 PECOS PAC ID: 1052592011 Enrollment ID: I20110223000922 |
| Provider Name | Dennis M Melton |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982604336 PECOS PAC ID: 2062419898 Enrollment ID: I20110510000218 |
| Provider Name | Terry Hackworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174895643 PECOS PAC ID: 4082872213 Enrollment ID: I20120220000827 |
| Provider Name | Nia Michelle Sipp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609905959 PECOS PAC ID: 9133381676 Enrollment ID: I20120501000215 |
| Provider Name | Metra Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881858470 PECOS PAC ID: 9133382955 Enrollment ID: I20120515000285 |
| Provider Name | Raulnina Uzzle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487790960 PECOS PAC ID: 7911193834 Enrollment ID: I20120515000316 |
| Provider Name | Akita Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801007026 PECOS PAC ID: 2365605102 Enrollment ID: I20120515000451 |
| Provider Name | Shaveandra Queen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972600922 PECOS PAC ID: 7012171663 Enrollment ID: I20120611000342 |
| Provider Name | Barbara Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770846453 PECOS PAC ID: 1052577715 Enrollment ID: I20120724000747 |
| Provider Name | Nkeiru Uwazie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952670291 PECOS PAC ID: 5597919712 Enrollment ID: I20130215000344 |
| Provider Name | Farrah Fang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982896809 PECOS PAC ID: 9234290255 Enrollment ID: I20130313000439 |
| Provider Name | Jonathan Guy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871746990 PECOS PAC ID: 8820286578 Enrollment ID: I20130813000270 |
| Provider Name | Mary A Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003244021 PECOS PAC ID: 0042446866 Enrollment ID: I20131126000450 |
| Provider Name | Felicia W English |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073943346 PECOS PAC ID: 4981833985 Enrollment ID: I20140218000412 |
| Provider Name | Marsha D Ford |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1730246836 PECOS PAC ID: 2466778394 Enrollment ID: I20150311001468 |
| Provider Name | Maria Martinez-barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952584112 PECOS PAC ID: 3577889344 Enrollment ID: I20150313001746 |
| Provider Name | Sawanarry R Forrest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700284098 PECOS PAC ID: 7315265261 Enrollment ID: I20150406001302 |
| Provider Name | Cindy Juster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730160342 PECOS PAC ID: 9830410075 Enrollment ID: I20150601000288 |
| Provider Name | Song Y Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568852317 PECOS PAC ID: 3779891973 Enrollment ID: I20151008001369 |
| Provider Name | Anuj Malik |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871766428 PECOS PAC ID: 2860552395 Enrollment ID: I20151106001420 |
| Provider Name | Ashleigh Igbokwe-hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568783124 PECOS PAC ID: 9133367030 Enrollment ID: I20151112000432 |
| Provider Name | Katrice Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154657625 PECOS PAC ID: 4587706486 Enrollment ID: I20151118000838 |
| Provider Name | Shannon L Ashley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619242922 PECOS PAC ID: 4688974769 Enrollment ID: I20151120001632 |
| Provider Name | Yvonka D Crenshaw |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164605010 PECOS PAC ID: 0143522904 Enrollment ID: I20160111001911 |
| Provider Name | Martha J Sipe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184098089 PECOS PAC ID: 1557664133 Enrollment ID: I20160115000522 |
| Provider Name | Valerie L Mainer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245580471 PECOS PAC ID: 9335434844 Enrollment ID: I20160823002301 |
| Provider Name | Kishore J. Thampy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659367951 PECOS PAC ID: 0143268904 Enrollment ID: I20160919001614 |
| Provider Name | Baron Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851750582 PECOS PAC ID: 7012203060 Enrollment ID: I20161005001598 |
| Provider Name | Katherine F Liang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003243494 PECOS PAC ID: 8325361298 Enrollment ID: I20170220002770 |
| Provider Name | Chelsea Bianca Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437567815 PECOS PAC ID: 6608193784 Enrollment ID: I20170605001371 |
| Provider Name | Beatrice Clodomir |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760640924 PECOS PAC ID: 8628347028 Enrollment ID: I20170628000782 |
| Provider Name | Brittany Torke |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1023406147 PECOS PAC ID: 8325313547 Enrollment ID: I20171013000827 |
| Provider Name | Katia Outlaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720495021 PECOS PAC ID: 8527379304 Enrollment ID: I20171016000989 |
| Provider Name | Lature E. Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043303019 PECOS PAC ID: 3678669801 Enrollment ID: I20180119002199 |
| Provider Name | Danielle J Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982052429 PECOS PAC ID: 4284994005 Enrollment ID: I20180215001601 |
| Provider Name | Anita Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801057427 PECOS PAC ID: 1557625977 Enrollment ID: I20180510000713 |
| Provider Name | Walter L Leeks |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801006754 PECOS PAC ID: 9436404365 Enrollment ID: I20180618003475 |
| Provider Name | Rachna Gadhok |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639355209 PECOS PAC ID: 0345327888 Enrollment ID: I20180712000737 |
| Provider Name | Jacqueline Woodard Clubine |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053812362 PECOS PAC ID: 1355697848 Enrollment ID: I20180713002259 |
| Provider Name | Richard A Onoja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493089 PECOS PAC ID: 4688926272 Enrollment ID: I20181009003460 |
| Provider Name | Jennifer A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922311372 PECOS PAC ID: 3678826757 Enrollment ID: I20181019002509 |
| Provider Name | Virginia A Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548625114 PECOS PAC ID: 5597018333 Enrollment ID: I20181025000645 |
| Provider Name | Ronalda Barie Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457855108 PECOS PAC ID: 3072852987 Enrollment ID: I20190311001292 |
| Provider Name | Yuri Okuizumi Wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548228034 PECOS PAC ID: 3375883127 Enrollment ID: I20190314001360 |
| Provider Name | Nyabilondi Huguette Ebama |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467618900 PECOS PAC ID: 1850562976 Enrollment ID: I20190329002291 |
| Provider Name | Chad Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013186964 PECOS PAC ID: 2365575941 Enrollment ID: I20190923002898 |
| Provider Name | April Anita Bright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194207126 PECOS PAC ID: 4880925106 Enrollment ID: I20191016003716 |
| Provider Name | Monique Merritt-atkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336594688 PECOS PAC ID: 1355637893 Enrollment ID: I20200122001220 |
| Provider Name | Donnett Crumbie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093114720 PECOS PAC ID: 3870817554 Enrollment ID: I20200429001904 |
| Provider Name | Lashanda Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205306891 PECOS PAC ID: 8325479140 Enrollment ID: I20200512001111 |
| Provider Name | Rodrick Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134507171 PECOS PAC ID: 4284949363 Enrollment ID: I20200625001261 |
| Provider Name | Katherine Michelle Mitchell-gregory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255864609 PECOS PAC ID: 3072937366 Enrollment ID: I20200720002157 |
| Provider Name | Lori Abramson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538784103 PECOS PAC ID: 6800210543 Enrollment ID: I20200728001091 |
| Provider Name | Julie B Sewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215584198 PECOS PAC ID: 4981015450 Enrollment ID: I20201204002460 |
| Provider Name | Shariah M Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689025991 PECOS PAC ID: 5294020012 Enrollment ID: I20210107000048 |
| Provider Name | Ashley Marie Blayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871058636 PECOS PAC ID: 0648679258 Enrollment ID: I20210602002191 |
| Provider Name | Jessica Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477161412 PECOS PAC ID: 2961801402 Enrollment ID: I20210603000371 |
| Provider Name | Rodneysha L Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205360732 PECOS PAC ID: 7719252758 Enrollment ID: I20210618000207 |
| Provider Name | Jessica Ochei |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659988434 PECOS PAC ID: 8527440395 Enrollment ID: I20220727001444 |
| Provider Name | Veda C Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780611996 PECOS PAC ID: 5193984854 Enrollment ID: I20220916000815 |
| Provider Name | Terri Mcfadden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174616874 PECOS PAC ID: 9133504871 Enrollment ID: I20220916001935 |
| Provider Name | Andrea Aline Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649262932 PECOS PAC ID: 3476638602 Enrollment ID: I20221214001634 |
| Provider Name | Janet Fedullo |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1841243318 PECOS PAC ID: 7012929557 Enrollment ID: I20230804002257 |
| Provider Name | Hellen Moges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366226128 PECOS PAC ID: 4385098862 Enrollment ID: I20231003000514 |
| Provider Name | Adena Marie Hicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164957049 PECOS PAC ID: 6709218308 Enrollment ID: I20231005003857 |
| Provider Name | Cindy Lebiecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346495827 PECOS PAC ID: 2264888676 Enrollment ID: I20231020002048 |
| Provider Name | Lynette Wilson-phillips |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992769269 PECOS PAC ID: 0042666182 Enrollment ID: I20231026001573 |
| Provider Name | Ka'nesha Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740993583 PECOS PAC ID: 4486001914 Enrollment ID: I20231106001409 |
| Provider Name | Runala Jaglal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699236653 PECOS PAC ID: 1355798745 Enrollment ID: I20231107000566 |
| Provider Name | Sheena Rene Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154745545 PECOS PAC ID: 6103218466 Enrollment ID: I20231113002424 |
| Provider Name | Ladean Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235603242 PECOS PAC ID: 0345583696 Enrollment ID: I20231128001941 |
| Provider Name | Gayla Woodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245656768 PECOS PAC ID: 5890131403 Enrollment ID: I20240306000311 |
| Provider Name | Mary E. Callaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316706187 PECOS PAC ID: 6103264585 Enrollment ID: I20240404000232 |
Gibraltar Biz, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5505 E Mountain St, Stone Mountain, GA 30083 Phone: 678-485-3308 | |
Salam Clinic Primary And Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5468 Memorial Dr Ste D, Stone Mountain, GA 30083 Phone: 404-963-2142 Fax: 404-963-2098 | |
Stone Mountain Family Practice, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087 Phone: 770-469-7000 Fax: 770-879-0436 | |
Elmore Alexander D.o.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 374 Osprey Pt, Stone Mountain, GA 30087 Phone: 678-371-2204 Fax: 678-805-0077 | |
Mercy Healthcare, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 Linsley Way, Stone Mountain, GA 30087 Phone: 404-933-8501 | |
Hope Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5300 Memorial Dr, Suite 110-112, Stone Mountain, GA 30083 Phone: 678-704-0306 Fax: 678-704-0706 | |
Rockbridge Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1192a Rockbridge Rd, Stone Mountain, GA 30087 Phone: 770-925-2010 Fax: 770-925-1665 |