NPIMap

Organization Active NPI

Home Physician Care, LLC

Doing business as Amerimed Mobile Integrated Healthare

  • General Practice Physician
  • Buford, GA
National Provider Identifier
1003047184
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HOME PHYSICIAN CARE, LLC
Doing business as
Amerimed Mobile Integrated Healthare
Practice address
5012 Bristol Industrial Way
Suite 110
Buford, GA 30518-9050
Phone
(770) 554-9773
Fax
(678) 730-4397
NPI assigned
Aug 6, 2009
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sally Lee ArnoldNPI 1437580255
Title
NP/Clinical Manager
Phone
(478) 973-1649

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5012 Bristol Industrial Way
Suite 110
Buford, GA 30518-9050

Mailing address

5012 Bristol Industrial Way
Suite 110
Buford, GA 30518-9050
Phone (770) 554-9773

Other practice location 1

787 Hillcrest Industrial Blvd Ste De
Macon, GA 31204-3482
Phone (478) 550-5971

Other names 1

  • Amerimed Mobile Integrated Healthare Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sally.round.1@14489.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20181214001779 GA Part B Supplier - Clinic/Group Practice 8325383672 Receives reassigned benefits from 15 practitioners
Practice locations: Buford, GA
O20230427002578 SC Part B Supplier - Clinic/Group Practice 8325383672 Receives reassigned benefits from 6 practitioners
Practice locations: Rock Hill, SC
O20240214001500 IL Part B Supplier - Clinic/Group Practice 8325383672 Receives reassigned benefits from 3 practitioners
Practice locations: Champaign, IL

National Provider Directory

National Provider Directory

Locations

5012 Bristol Industrial Way
Buford, GA 30518

5012 Bristol Industrial Way
Ste 109
Buford, GA 30518
Phone (478) 251-4129

787 Hillcrest Industrial Blvd
Ste De
Macon, GA 31204
Phone (478) 550-5971

303 S Staley Rd
Champaign, IL 61822
Phone (770) 554-9773

1672 Overview Dr
Ste 107
Rock Hill, SC 29730

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14489/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sally.round.1@14489.direct.athenahealth.com

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1003047184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 BRISTOL INDUSTRIAL WAY",
            "address_2": "SUITE 110",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305189050",
            "telephone_number": "770-554-9773",
            "fax_number": "678-730-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 BRISTOL INDUSTRIAL WAY",
            "address_2": "SUITE 110",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305189050",
            "telephone_number": "770-554-9773",
            "fax_number": "678-730-4397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "787 Hillcrest Industrial Blvd Ste De",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312043482",
            "country_code": "US",
            "telephone_number": "478-550-5971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOME PHYSICIAN CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "NP/CLINICAL MANAGER",
        "authorized_official_telephone_number": "478-973-1649"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sally.round.1@14489.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "5012 Bristol Industrial Way",
            "address_2": "Suite 110",
            "city": "Buford",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305189050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Amerimed Mobile Integrated Healthare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.