Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northside Primary Care Professional Services, LLC

Organization Family Medicine Physician · NPI 1922397553

Northside Primary Care Professional Services, LLC is a Family Medicine Physician in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone: (855) 709-4535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (GA)

Record details

NPI number1922397553
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationNorthside Hospital, Inc
Authorized official Amy Fouts — Chief Compliance Officer · (404) 851-6968
NPI enumeratedApril 5, 2011
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026
Mailing address1000 Johnson Fy Rd Ne, Atlanta, GA 30342-1606

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