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ST. JUDE'S INTERNAL MEDICINE, LLC
NPI 1477863579
Specialist in Woodstock, GA

Active since October 07, 2010
1198 BUCKHEAD XING, STE C, WOODSTOCK, GA 30189(678) 324-7406(770) 627-4322 Get Directions Write a Review

NPPES record last updated: May 8, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About St. Jude's Internal Medicine, Llc NPPES

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

ST. JUDE'S INTERNAL MEDICINE, LLC (NPI 1477863579) is a healthcare organization registered as a specialist in Woodstock, Georgia and active in the NPI registry since October 2010. The organization lists Osborne F D'souza, Provider, as its authorized official.

NPPES Registry Identity

NPI1477863579
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameST. JUDE'S INTERNAL MEDICINE, LLC
Location Address1198 BUCKHEAD XING, STE CWoodstock, GA 30189-4257
Mailing Address1198 Buckhead Xing, Ste CWoodstock, GA 30189-4257 · (678) 324-7406 · Fax (770) 627-4322
Phone(678) 324-7406
Fax(770) 627-4322
Organization SubpartNo
Authorized OfficialOsborne F D'souzaProvider · (678) 324-7406
Enumeration DateOctober 7, 2010
Last NPPES UpdateMay 8, 2014
✔ NPI 1477863579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1198 BUCKHEAD XING, Woodstock, GA 30189
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Waiver 11D2010335

St Jude's Internal Medicine, LLC · Woodstock, GA
Expired · Jul 25, 2026
CLIA Number11D2010335
Laboratory TypePhysician Office
Certificate Effective DateJuly 26, 2024
Certificate Expiration DateJuly 25, 2026
Laboratory DirectorOsborne F. D Souza
Laboratory Phone(678) 324-7406
Laboratory LocationSt Jude's Internal Medicine, LLC1198 Buckhead Crossing, Suite C, Woodstock, GA 30189
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SERENITY MEDICAL, LLC
Durable Medical Equipment & Medical Supplies
1198 BUCKHEAD XING, SUITE B
WOODSTOCK, GA 30189
Cherokee County (770) 591-0704
DR. OSBORNE D'SOUZA MD
Internal Medicine
1198 BUCKHEAD XING, SUITE C
WOODSTOCK, GA 30189
Cherokee County (678) 324-7406
STEVEN A WEISKOPF D.P.M.
Podiatrist
1198 BUCKHEAD XING, SUITE D
WOODSTOCK, GA 30189
Cherokee County (770) 928-9263

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 St. Jude's Internal Medicine, LLC's NPI number?

The NPI number for St. Jude's Internal Medicine, LLC is 1477863579. It was assigned to this organization in the NPPES registry on October 7, 2010.

Where is St. Jude's Internal Medicine, LLC located?

St. Jude's Internal Medicine, LLC is located at 1198 Buckhead Xing Ste C, Woodstock, GA 30189. The listed phone number is (678) 324-7406.

What is St. Jude's Internal Medicine, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

What insurance does St. Jude's Internal Medicine, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list St. Jude's Internal Medicine, 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 St. Jude's Internal Medicine, LLC was last updated on May 8, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.