DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1891745212

NPI Code Detail

MEDICARE: NORTHEAST GEORGIA PHYSICIANS GROUP INC

MEDICARE: NORTHEAST GEORGIA PHYSICIANS GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician
2	363L00000X	Nurse Practitioner
3	208800000X	Urology Physician
4	208D00000X	General Practice Physician
5	207R00000X	Internal Medicine Physician
6	207RC0000X	Cardiovascular Disease Physician
7	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
8	2084N0400X	Neurology Physician
9	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
10	207P00000X	Emergency Medicine Physician
11	207LC0200X	Critical Care Medicine (Anesthesiology) Physician
12	363A00000X	Physician Assistant
13	207QS0010X	Sports Medicine (Family Medicine) Physician
14	207T00000X	Neurological Surgery Physician
15	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GRP 4221	OTHER	GA	MEDICARE GRP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891745212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST GEORGIA PHYSICIANS GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 742616
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-2616
Country	:	US
Telephone Number	:	770-219-8420
Fax Number	:	770-219-8440

Provider Business Practice Location Address
First Line	:	743 SPRING ST NE
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3715
Country	:	US
Telephone Number	:	770-219-9000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, CBO
Name	:	KAREN REYER
Credential	:
Telephone Number	:	770-219-8051

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/02/2025

Similar Medicare Providers

1992705131 — DEANINE M ANGOTTI PA
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 770-219-9000
Practice Fax:

1194145862 — DONNA COTA DO
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 770-219-9000
Practice Fax:

1275038671 — DR. WILLIAM AUSTIN FORSHEE DO
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 386-274-7118
Practice Fax:

1063533149 — DR. AJAY KUMAR RAVI M.D.
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 770-219-9000
Practice Fax:

1972363166 — ANNA HAYDEN MD
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 770-219-9000
Practice Fax:

1003519653 — DR. SHARANI UMAYANGANI JAYARATNE MD
Practice Location Address:

743 SPRING ST NE
GAINESVILLE, GA
30501-3715

Practice Phone: 770-219-1200
Practice Fax:

Directions to “NORTHEAST GEORGIA PHYSICIANS GROUP INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.