OAK STREET HEALTH OF GEORGIA PC NPI 1588258024

NPI Information

NPI: 1588258024
Provider Name: OAK STREET HEALTH OF GEORGIA PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2214246

Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
ZIP 30087
Phone: (470) 444-3134
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OAK STREET HEALTH OF GEORGIA PC is a primary care clinic center in Stone Mountain, GA. OAK STREET HEALTH OF GEORGIA PC NPI is 1588258024. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
ZIP 30087-306
Phone: (470) 444-3134
Fax: (470) 276-4370

The provider's authorized official is Griffin R Myers .
The authorized official title is Cmo and has the following contact phone number (307) 264-2085.

The CLIA number assigned to this NPI record is 11D2214246 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2021 and was last updated on 6/29/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207R00000X	Internal Medicine		No
2	363L00000X	Nurse Practitioner		No
3	363LF0000X	Nurse Practitioner	Family	No
4	1041C0700X	Social Worker	Clinical	No
5	207Q00000X	Family Medicine		No
6	261QP2300X	Clinic/Center	Primary Care	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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