MINI-MED CLINIC OF NORTH GEORGIA – NPI #1124792106
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Health Care Provider Taxonomy Code for Clinic/Center

MINI-MED CLINIC OF NORTH GEORGIA is an AHC clinic located in CANTON, GA. NPPES has assigned the NPI number 1124792106 to MINI-MED CLINIC OF NORTH GEORGIA on August 04, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MINI-MED CLINIC OF NORTH GEORGIA” is a dba name, the actual legal business name for this organization is MINI-MED CLINIC OF NORTH GEORGIA, LLC. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 5 years ago on Aug 27, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MINI-MED CLINIC OF NORTH GEORGIA below.

NPI Profile for
MINI-MED CLINIC OF NORTH GEORGIA, LLC

NPI Number
1124792106
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MINI-MED CLINIC OF NORTH GEORGIA, LLC
Doing Business As (dba): MINI-MED CLINIC OF NORTH GEORGIA
Primary location
5113 HOLLY SPRINGS PARKWAY
CANTON, GA 30115
Phone: (470) 331-3544 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SOPHIA KENNEDY
NURSE PRACTITIONER
Phone: (678) 398-9697
Updated
Certification Date
Aug 27, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.