Mini-Med Clinic of North Georgia, LLC
NPI 1124792106ActiveOrganization· Clinic/Center· Canton, GA
Clinic/Center in Canton, Georgia, registered in NPPES in August 2021. The authorized official on file is Sophia Kennedy, NP, Nurse Practitioner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124792106 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 4, 2021 |
| Last updated in NPPES | Aug 27, 2021 |
| Certified by provider | Aug 27, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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