| NPI Number | 1942802061 |
| Provider Name | Morehouse Healthcare, Inc. |
| Authorized Official | Name: Jasmine Bajnath Title: Credentialing Manager Phone: 404-756-1400 |
| Status | |
| Entity Type | Organization |
| Enumeration Date | 11/13/2020 |
| Last Update Date | 11/13/2020 |
| Organization Subpart | Y |
| Business Practice address |
455 LEE STREET, 3RD FLOOR, Atlanta, 30310 Georgia View on Google Map |
| Business Practice phone | 404-756-1400 |
| Business Practice fax | |
| Mailing address |
455 LEE STREET, 3RD FLOOR, Atlanta, 30310 Georgia View on Google Map |
| Other phone | 404-756-1400 |
| Other fax | |
| Email Address | shannonfig@domain.com Reval Email Address |
| Field Name | Field Value |
|---|---|
| NPI | 1942802061 |
| 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
| Entity Type | Organization |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
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| Is Organization Subpart | Y |
| The "Is the organization a subpart?" question must be answered. If the organization is a subpart = , the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don't know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI. | |
| Parent Organization LBN | Morehouse Healthcare, Inc. |
| If the organization is a subpart, the Parent Organization Legal Business Name (LBN) field must be completed. The Parent Organization LBN field can only be completed if the answer to the subpart question is Yes. | |
| Provider Organization Name (Legal Business Name) | Morehouse Healthcare, Inc. |
| Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
| Provider First Line Business Mailing Address | 455 LEE STREET, 3RD FLOOR |
| The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''. | |
| Provider Business Mailing Address City Name | Atlanta |
| The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
| Provider Business Mailing Address State Name | Georgia |
| The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. | |
| Provider Business Mailing Address Postal Code | 30310 |
| The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''. | |
| Provider Business Mailing Address Country Code | US |
| The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. | |
| Provider Business Mailing Address Telephone Number | 404-756-1400 |
| The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''. | |
| Provider First Line Business Practice Location Address | 455 LEE STREET, 3RD FLOOR |
| The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. | |
| Provider Business Practice Location Address City Name | Atlanta |
| The city name in the location address of the provider being identified. | |
| Provider Business Practice Location Address State Name | Georgia |
| The State or Province name in the location address of the provider being identified. | |
| Provider Business Practice Location Address Postal Code | 30310 |
| The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
| Provider Business Practice Location Address Country Code | US |
| The country code in the location address of the provider being identified. | |
| Provider Business Practice Location Address Telephone Number | 404-756-1400 |
| The telephone number associated with the location address of the provider being identified. | |
| Provider Enumeration Date | 11/13/2020 |
| The date the provider was assigned a unique identifier (assigned an NPI). | |
| Last Update Date | 11/13/2020 |
| The date that a record was last updated or changed. | |
| Authorized Official Last Name | Bajnath |
| The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. | |
| Authorized Official First Name | Jasmine |
| The first name of the authorized official | |
| Authorized Official Title or Position | Credentialing Manager |
| The title or position of the authorized official | |
| Authorized Official Telephone Number | 404-756-1400 |
| The 10-position telephone number of the authorized official. | |
| Healthcare Provider Taxonomy Code #1 | 2085H0002X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 1 | A radiologist with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Healthcare Provider Taxonomy #1 | |
| Healthcare Provider Primary Taxonomy Switch 1 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Group 1 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 1 | |
| Healthcare Provider Taxonomy Code #2 | 2085N0700X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 2 | A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Healthcare Provider Taxonomy #2 | |
| Healthcare Provider Primary Taxonomy Switch 2 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 2 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 2 | |
| Healthcare Provider Taxonomy Code #3 | 2085R0001X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 3 | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Healthcare Provider Taxonomy #3 | |
| Healthcare Provider Primary Taxonomy Switch 3 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 3 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 3 | |
| Healthcare Provider Taxonomy Code #4 | 2085R0202X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 4 | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Healthcare Provider Taxonomy #4 | |
| Healthcare Provider Primary Taxonomy Switch 4 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Group 4 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 4 | |
| Healthcare Provider Taxonomy Code #5 | 2085R0203X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 5 | Definition to come... |
| Healthcare Provider Taxonomy #5 | |
| Healthcare Provider Primary Taxonomy Switch 5 | N |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Group 5 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 5 | |
| Healthcare Provider Taxonomy Code #6 | 2085R0204X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 6 | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Healthcare Provider Taxonomy #6 | |
| Healthcare Provider Primary Taxonomy Switch 6 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 6 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 6 | |
| Healthcare Provider Taxonomy Code #7 | 2085N0904X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 7 | A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. |
| Healthcare Provider Taxonomy #7 | |
| Healthcare Provider Primary Taxonomy Switch 7 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 7 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 7 | |
| Healthcare Provider Taxonomy Code #8 | 2085N0904X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 8 | A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. |
| Healthcare Provider Taxonomy #8 | |
| Healthcare Provider Primary Taxonomy Switch 8 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 8 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 8 | |
| Healthcare Provider Taxonomy Code #9 | 2085D0003X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 9 | A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging. |
| Healthcare Provider Taxonomy #9 | |
| Healthcare Provider Primary Taxonomy Switch 9 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 9 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 9 | |
| Healthcare Provider Taxonomy Code #10 | 2085R0205X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 10 | A radiological physicist deals with the diagnostic and therapeutic applications of roentgen rays, gamma rays from sealed sources, ultrasonic radiation and radio-frequency radiation, as well as the equipment associated with their production and use, including radiation safety. |
| Healthcare Provider Taxonomy #10 | |
| Healthcare Provider Primary Taxonomy Switch 10 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 10 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 10 | |
| Healthcare Provider Taxonomy Code #11 | 2085U0001X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 11 | A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. |
| Healthcare Provider Taxonomy #11 | |
| Healthcare Provider Primary Taxonomy Switch 11 | N |
Primary Taxonomy:
|
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| Healthcare Provider Taxonomy Group 11 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 11 | |
| Healthcare Provider Taxonomy Code #12 | 2085B0100X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 12 | A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Healthcare Provider Taxonomy #12 | |
| Healthcare Provider Primary Taxonomy Switch 12 | Y |
Primary Taxonomy:
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| Healthcare Provider Taxonomy Group 12 | 193200000X MULTI-SPECIALTY GROUP |
| Healthcare Provider Taxonomy Group 12 |
