Supreme Healthcare OB/GYN LLC
NPI 1639552649ActiveOrganization· Specialist· Decatur, GA
Specialist in Decatur, Georgia, registered in NPPES in July 2015. The authorized official on file is Kimar Dunn, Assistant Practice Manager.
Overview
| NPI | 1639552649 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2015 |
| Last updated in NPPES | Jul 8, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 57621 | GA |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Specialist providers in Decatur
- 1023033305
- 1326029125
- 1396738613
- 1588653976
- 1861481400
- 1184608838
- 1619995271
- 1063560803
- 1063563013
- 1144675661
- 1184706087
- 1215052261
All 55 Specialist providers in Decatur · All Specialist providers in Georgia