JUDITH RUTH MEDICAL CENTER LLC NPI 1144912270

NPI Information

  • NPI: 1144912270
  • Provider Name: JUDITH RUTH MEDICAL CENTER LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • :
  • CLIA Number: 11D2283287
  • Address: 10494 VETERANS MEMORIAL HWY STE 5
    LITHIA SPRINGS, GA
    ZIP 30122
  • Phone: (404) 793-3806

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NPI Details

JUDITH RUTH MEDICAL CENTER LLC is a family nurse practitioner in Lithia Springs, GA. JUDITH RUTH MEDICAL CENTER LLC NPI is 1144912270. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

10494 VETERANS MEMORIAL HWY STE 5
LITHIA SPRINGS, GA
ZIP 30122-061
Phone: (404) 793-3806
Fax: (770) 502-6715

The provider's authorized official is Natalie Mccall-gaston .
The authorized official title is Ceo/founder and has the following contact phone number (404) 793-3806.

The CLIA number assigned to this NPI record is 11D2283287 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2023 and was last updated on 3/25/2025.

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 License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2363LF0000XNurse PractitionerFamilyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003137957DMEDICAIDGEORGIA

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: 3/30/2025

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