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NPI Code Detail

MEDICARE: NORTHSIDE HOSPITAL, INC.

MEDICARE: NORTHSIDE HOSPITAL, 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
1282N00000XGeneral Acute Care Hospital067-460GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952340994
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHSIDE HOSPITAL, INC.
Provider Business Mailing Address
First Line : 1000 JOHNSON FY RD NE
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30342-1606
Country : US
Telephone Number : 404-851-6378
Fax Number :
Provider Business Practice Location Address
First Line : 1000 MEDICAL CENTER BLVD
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30046-7694
Country : US
Telephone Number : 678-312-1000
Fax Number :
Authorized Official
Title or Position : CHIEF COMPLIANCE OFFICER
Name : AMY E FOUTS
Credential :
Telephone Number : 404-851-6968
Provider Enumeration Date : 06/05/2006
Last Update Date : 06/12/2026

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