NORTHSIDE CARDIOVASCULAR INSTITUTE LLC
NPI 1962060368
Internal Medicine - Cardiovascular Disease in Atlanta, GA

Q: What is Northside Cardiovascular Institute LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Active since May 31, 2019CLIA 11D2169502 · Waiver

1110 W PEACHTREE ST NW STE 920, ATLANTA, GA 30309(855) 709-4535 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2025, Jan 11, 2023, Dec 3, 2019 and 2 more (5 updates tracked since 2019).

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About Northside Cardiovascular Institute Llc NPPES

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

NORTHSIDE CARDIOVASCULAR INSTITUTE LLC (NPI 1962060368) is a healthcare organization registered as a cardiovascular disease in Atlanta, Georgia and active in the NPI registry since May 2019. The organization holds a CLIA Waiver certificate valid through July 22, 2027 and lists Jorge J. Hernadez, Vp Admin & Svcs. / Cco, as its authorized official.

NPPES Registry Identity

NPI1962060368

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NameNORTHSIDE CARDIOVASCULAR INSTITUTE LLC

Location Address1110 W PEACHTREE ST NW STE 920Atlanta, GA 30309-3609

Mailing Address1000 Johnson Ferry Road, N.e., Attn: Jorge HernandezAtlanta, GA 30342-1606 · (404) 851-6378

Phone(855) 709-4535

Organization SubpartNo

Authorized OfficialJorge J. HernadezVp Admin & Svcs. / Cco · (404) 851-6378

Enumeration DateMay 31, 2019

Last NPPES UpdateJune 3, 20255 updates tracked since enumeration

NPPES CertifiedJune 3, 2025

✔ NPI 1962060368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1110 W PEACHTREE ST NW STE 920, Atlanta, GA 30309

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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

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 11D2169502

Northside Cardiovascular Institute · Atlanta, GA

Active · expires Jul 22, 2027

CLIA Number11D2169502

Laboratory TypePhysician Office

Certificate Effective DateJuly 23, 2025

Certificate Expiration DateJuly 22, 2027

Laboratory DirectorPradyumna Tummala

Laboratory Phone(404) 962-6000

Laboratory LocationNorthside Cardiovascular Institute1110 W Peachtree Street, NW, Suite 920, Atlanta, GA 30309

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

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

DR. MARK ERIC LEIMBACH MD

Internal Medicine (Interventional Cardiology)