NORTHSIDE HOSPITAL INC. NPI 1396788428

NPI Information

  • NPI: 1396788428
  • Provider Name: NORTHSIDE HOSPITAL, INC.
  • Classification: Skilled Nursing Facility - 314000000X
  • Entity Type: Organization
  • Doing Business As: NORTHSIDE GWINNETT EXTENDED CARE CENTER
  • Address: 650 PROFESSIONAL DR
    LAWRENCEVILLE, GA
    ZIP 30046
  • Phone: (678) 312-3000

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NPI Details

NORTHSIDE HOSPITAL, INC. is a skilled nursing facility in Lawrenceville, GA. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. NORTHSIDE HOSPITAL, INC. NPI is 1396788428. The provider is registered as an organization entity type.
The provider Is Doing Business As Northside Gwinnett Extended Care Center.

The provider's business location address is:

650 PROFESSIONAL DR
LAWRENCEVILLE, GA
ZIP 30046-707
Phone: (678) 312-3000
Fax: (678) 312-3065

The provider's authorized official is Jorge Hernandez .
The authorized official title is Vp Admin; Cco and has the following contact phone number (404) 851-6378.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 9/18/2019.

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
1314000000XSkilled Nursing Facility067-460GEORGIAYes

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
1781382AMEDICAIDGEORGIA

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: 11/21/2025

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