| Traditions Health | |
|
497 Rome St Carrollton GA 30117-3108 | |
| (770) 462-1047 | |
| Not Available |
| Full Name | Traditions Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 497 Rome St, Carrollton, Georgia |
| Authorized Official Name and Position | John Kerndl (CFO & SECRETARY) |
| Authorized Official Contact | 9797046547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Health 6840 Carothers Pkwy Ste 550 Franklin TN 37067-8002 Ph: (979) 704-6547 | Traditions Health 497 Rome St Carrollton GA 30117-3108 Ph: (770) 462-1047 |
| NPI Number | 1336864875 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 06/21/2024 |
| Medicare PECOS PAC ID | 4183034382 |
|---|---|
| Medicare Enrollment ID | O20221107000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336864875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Anthony G Captain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023035094 PECOS PAC ID: 0749259661 Enrollment ID: I20050228000463 |
| Provider Name | Kathalina V Lacoste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255459335 PECOS PAC ID: 9335182211 Enrollment ID: I20050602000553 |
| Provider Name | Alana M Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578519161 PECOS PAC ID: 1557260247 Enrollment ID: I20090428000223 |
| Provider Name | Catherine N Kiarie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548692270 PECOS PAC ID: 7012151491 Enrollment ID: I20130925000545 |
| Provider Name | Sherry Lee Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871015362 PECOS PAC ID: 9335412402 Enrollment ID: I20170912001982 |
| Provider Name | Heather M. Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861032187 PECOS PAC ID: 2062840812 Enrollment ID: I20210726002596 |
| Provider Name | Brooklyn M Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598439648 PECOS PAC ID: 5395133870 Enrollment ID: I20211103000219 |
| Provider Name | Eldine Garraud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992589691 PECOS PAC ID: 1759727837 Enrollment ID: I20240312000425 |
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