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GWINNETT CLINIC, LTD
NPI 1255342630
Clinic/Center - Multi-Specialty in Loganville, GA

Active since August 10, 2006
4397 ATLANTA HWY, LOGANVILLE, GA 30052(770) 554-0800(770) 554-0080 Get Directions Write a Review

NPPES record last updated: January 24, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gwinnett Clinic, Ltd NPPES

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

GWINNETT CLINIC, LTD (NPI 1255342630) is a healthcare organization registered as a multi-specialty in Loganville, Georgia and active in the NPI registry since August 2006. The organization lists Deep Shah, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1255342630
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameGWINNETT CLINIC, LTD
Location Address4397 ATLANTA HWYLoganville, GA 30052-2642
Mailing Address10600 Medlock Bridge RdDuluth, GA 30097-8404
Phone(770) 554-0800
Fax(770) 554-0080
Organization SubpartNo
Authorized OfficialDeep ShahAuthorized Official · (770) 995-3300
Enumeration DateAugust 10, 2006
Last NPPES UpdateJanuary 24, 2023
NPPES CertifiedJanuary 24, 2023
✔ NPI 1255342630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedLegal MedicineTaxonomy 173000000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
4397 ATLANTA HWY, Loganville, GA 30052
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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 for Provider-Performed Microscopy Procedures (PPMP) 11D0993813

Northside Loganville Primary Care · Loganville, GA
Expired · Nov 26, 2025
CLIA Number11D0993813
Laboratory TypePhysician Office
Certificate Effective DateNovember 27, 2023
Certificate Expiration DateNovember 26, 2025
Laboratory DirectorMichael R. Munsey
Laboratory Phone(770) 554-4717
Laboratory LocationNorthside Loganville Primary Care115 Lee Byrd Road, Loganville, GA 30052
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions

What is GWINNETT CLINIC, LTD's NPI number?

The NPI number assigned to this healthcare provider is 1255342630, enumerated as an "organization" on August 10, 2006.

Where is the provider located?

The provider is located at 4397 ATLANTA HWY LOGANVILLE, GA 30052 and the phone number is (770) 554-0800.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.

What insurance does GWINNETT CLINIC, LTD accept?

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.