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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
NPI 1144719311
Clinic/Center - Multi-Specialty in Gainesville, GA

Active since May 03, 2018CLIA 11D2163211 · Accreditation
1240 JESSE JEWELL PKWY SE STE 500, GAINESVILLE, GA 30501(855) 709-4535 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 3, 2026, Jun 2, 2025, Jan 11, 2023 and 2 more (5 updates tracked since 2018).

About Northeast Georgia Diagnostic Associates And Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC (NPI 1144719311) is a healthcare organization registered as a multi-specialty in Gainesville, Georgia and active in the NPI registry since May 2018. The organization holds an CLIA Accreditation certificate valid through July 30, 2027, maintains 2 additional practice locations, and lists Amy E Fouts, Chief Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1144719311
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameNORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
Location Address1240 JESSE JEWELL PKWY SE STE 500Gainesville, GA 30501-3861
Mailing Address1100 Johnson Fy Rd Ne Ste 780Atlanta, GA 30342-1743
Phone(855) 709-4535
Organization SubpartNo
Authorized OfficialAmy E FoutsChief Compliance Officer · (404) 851-6968
Enumeration DateMay 3, 2018
Last NPPES UpdateSeptember 3, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2026
✔ NPI 1144719311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1240 JESSE JEWELL PKWY SE STE 500, Gainesville, GA 30501
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11485 Jesse Jewell Pkwy NE Ste 330Gainesville, GA 30501-3896 · Phone (470) 228-7700
Location 21255 Friendship Rd Ste 230Braselton, GA 30517-5620 · Phone (470) 228-7700

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 11D2163211

Northeast Georgia Diagnostic Associates And Clinic (riverstone) · Braselton, GA
Active · expires Jul 30, 2027
CLIA Number11D2163211
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorAndre M. Kallab
Laboratory Phone(470) 228-7700
Laboratory LocationNortheast Georgia Diagnostic Associates And Clinic (riverstone)1255 Friendship Road, Suite 230, Braselton, GA 30517
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELLEY CHARMAINE MARTIN CNP
Nurse Practitioner
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
TERRI PENNA KEMMERER CNP
Nurse Practitioner (Family)
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
MS. MELISSA DAVIS SUMMERLIN NP-C
Nurse Practitioner (Adult Health)
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
DR. VIVEK SUNNY SAMBHARA M.D.
Internal Medicine (Pulmonary Disease)
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
DR. YASHSWEE KC MD
Internal Medicine (Rheumatology)
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
Durable Medical Equipment & Medical Supplies
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
MR. ALEXANDER POLSINELLI PA
Physician Assistant
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864
DEEP SHIKHA MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA 30501
Hall County (770) 536-9864

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Georgia Diagnostic Associates And Clinic, LLC's NPI number?

The NPI number for Northeast Georgia Diagnostic Associates And Clinic, LLC is 1144719311. It was assigned to this organization in the NPPES registry on May 3, 2018.

Where is Northeast Georgia Diagnostic Associates And Clinic, LLC located?

Northeast Georgia Diagnostic Associates And Clinic, LLC is located at 1240 Jesse Jewell Pkwy SE Ste 500, Gainesville, GA 30501. The listed phone number is (855) 709-4535.

What is Northeast Georgia Diagnostic Associates And Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Northeast Georgia Diagnostic Associates And Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 11D2163211) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northeast Georgia Diagnostic Associates And Clinic, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Northeast Georgia Diagnostic Associates And Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northeast Georgia Diagnostic Associates And Clinic, LLC was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.