1033229638 NPI number — MR. SCOTT D. HELMS PA-C

Table of content: MR. SCOTT D. HELMS PA-C (NPI 1033229638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033229638 NPI number — MR. SCOTT D. HELMS PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELMS
Provider First Name:
SCOTT
Provider Middle Name:
D.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033229638
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 HOWELL MILL RD NW STE 800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30318-0922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-350-9853
Provider Business Mailing Address Fax Number:
404-477-1162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 HOWELL MILL RD NW STE 800
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30318-0922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-350-9853
Provider Business Practice Location Address Fax Number:
404-350-8407
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  003123 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 320287 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 100000951A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1153760002 . This is a "PEACHSTATE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 970009101 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 10033125 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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