MOMENTUM PRIMARY CARE – NPI #1043612922
Clinic/Center

MOMENTUM PRIMARY CARE is an AHC clinic located in TYRONE, GA. NPPES has assigned the NPI number 1043612922 to MOMENTUM PRIMARY CARE on September 22, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MOMENTUM PRIMARY CARE” is a dba name, the actual legal business name for this organization is HDH HEALTHCARE GROUP, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QU0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Urgent Care

The NPI profile was previously updated about 5 years ago on Mar 26, 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 MOMENTUM PRIMARY CARE below.

NPI Profile for
HDH HEALTHCARE GROUP, LLC

NPI Number
1043612922
Enumeration Date

(more than 11 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
HDH HEALTHCARE GROUP, LLC
Doing Business As (dba): MOMENTUM PRIMARY CARE
Primary location
120 HANDLEY RD
#400
TYRONE, GA 30290-2177
Phone: (404) 597-9523 Fax:
Mailing address
PO BOX 935719
ATLANTA, GA 31193-2177
Phone: (678) 430-8478 Fax:
Organization Subpart
Yes - MOMENTUM PRIMARY CARE is subpart of another organization.
Authorized Official
JARED DERANEY
OWNER
Phone: (480) 482-0934
Updated
Certification Date
Mar 26, 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.

Identifiers

Identifiers for MOMENTUM PRIMARY CARE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDGA00469092A
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
261QU0200X
- Clinic/Center / Urgent Care (Primary)
207R00000X
- Internal Medicine		 GA 033776

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.