NPI age
14 years
Enumerated 2011-10-26
● Active Type 2 · Organization
Old National Primary Care Clinic, Llc
Old National Primary Care Clinic, Llc is 1 of 5027 internal medicine organizations in Georgia.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Beaulieu
Owner
Last NPPES update
2013-05-10
Source: monthly bulk 2026-05
How this organization compares
Across 5027 active internal medicine providers in Georgia.
NPI age
14 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-10Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
5185 Old National Hwy
Atlanta, GA 303493244
Mailing address
1065 Jodeco Rd
Stockbridge, GA 302814953
Authorized official
Eva Isabelle Beaulieu, M.D.
Owner
📞 7865560495
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Nikole Flowers Nurse Practitioner NPI 1194278622
- Tanisha Hooker, FNP Nurse Practitioner NPI 1922449149
- Omar Queensbourrow, PA Physician Assistant NPI 1841534591
- Kailyn Slack, NP Nurse Practitioner NPI 1962981126
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.