COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE NPI 1679917835

NPI Information

  • NPI: 1679917835
  • Provider Name: COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 11D1020820
  • Address: 960 JOHNSON FERRY RD NE
    SUITE 543
    ATLANTA, GA
    ZIP 30342
  • Phone: (678) 205-9004

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NPI Details

COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE is an internal medicine in Atlanta, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. COMPREHENSIVE INTERNAL MEDICINE AT NORTHSIDE NPI is 1679917835. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

960 JOHNSON FERRY RD NE
SUITE 543
ATLANTA, GA
ZIP 30342-631
Phone: (678) 205-9004

The provider's authorized official is Jacqueline T Pearson .
The authorized official title is Md Owner and has the following contact phone number (678) 205-9004.

The CLIA number assigned to this NPI record is 11D1020820 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2013 and was last updated on 5/3/2013.

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
1207R00000XInternal MedicineYes

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
1H00715MEDICARE UPINGEORGIA
2H73794MEDICARE UPINGEORGIA
3G90438MEDICARE UPINGEORGIA

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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