Provider Demographics
NPI:1376145318
Name:ROSS AND ASSOCIATES MEDICAL PARTNERS LLC
Entity Type:Organization
Organization Name:ROSS AND ASSOCIATES MEDICAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANTRANIKA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-749-5702
Mailing Address - Street 1:145 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4703
Mailing Address - Country:US
Mailing Address - Phone:678-749-5702
Mailing Address - Fax:
Practice Address - Street 1:33 UPPER RIVERDALE RD SW STE 107
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2642
Practice Address - Country:US
Practice Address - Phone:678-489-6734
Practice Address - Fax:888-498-4760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty