1366462699 NPI number — DR. ADRIENNE ATKINSON-SNEED DPM

Table of content: DR. ADRIENNE ATKINSON-SNEED DPM (NPI 1366462699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366462699 NPI number — DR. ADRIENNE ATKINSON-SNEED DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATKINSON-SNEED
Provider First Name:
ADRIENNE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ATKINSON
Provider Other First Name:
ADRIENNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1366462699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1046 RIDGE AVE SW
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:
30315-1640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-688-1350
Provider Business Mailing Address Fax Number:
404-564-6972

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3485 N DESERT DR STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST POINT
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30344-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-740-7000
Provider Business Practice Location Address Fax Number:
770-790-4752
Provider Enumeration Date:
07/20/2006

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: 213E00000X , with the licence number:  602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP0504X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP0504X , with the licence number: POD000984 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP1101X , with the licence number: POD000984 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP1101X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ER0200X , with the licence number: POD000984 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ER0200X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0000X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0000X , with the licence number: POD000984 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0103X , with the licence number: POD000948 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0131X , with the licence number: 602 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ES0131X , with the licence number: POD000984 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: POD000984 , 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: 4914320001 . This is a "DME REGION C" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 4914320001 . This is a "DME PTAN DR. A OLD INDIVIDUAL (PALMETTO GBA NSC) THORNTON" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 562310257 . This is a "TRICARE/HUMANA MILITARY" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 535013601A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10055437 . This is a "AMERIGROUP" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1457508681 . This is a "NPI GROUP CC" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 511I480053 . This is a "MEDICARE INDIVIDUAL PTAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: DQ9092 . This is a "MEDICARE RR GROUP PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1356598593 . This is a "NPI GROUP SC" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 6169580001 . This is a "PALMETTO GBA NSC (DME) PTAN CC" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 1790931483 . This is a "CAHABA GROUP NPI" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 6169580001 . This is a "GROUP PTAN CC" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 6169580003 . This is a "GROUP PTAN THORNTON" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 9277 . This is a "MEDICARE GROUP PTAN (PALMETTO GBA)" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1790931483 . This is a "MEDICARE GA GROUP NPI (CAHABA)" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 510504808 . This is a "HUMANA/TRICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 511G700902 . This is a "MEDICARE (CAHABA) GROUP PTAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: P00886457 . This is a "MEDICARE RR INDIV PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA39809277 . This is a "MEDICARE (PALMETTO GBA) INDIV PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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