NPIMap

Organization Active NPI

Meadows Med Group Inc

  • Family Medicine Physician
  • Tucker, GA
National Provider Identifier
1003125881
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
054181 Issued in GA
Legal business name
MEADOWS MED GROUP INC
Practice address
4426 Hugh Howell Rd
Ste 429
Tucker, GA 30084-4918
Phone
(404) 667-9648
NPI assigned
Sep 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
David DerrerNPI 1659378412
Title
Ceo
Phone
(404) 667-9648

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 054181 GA Primary

Addresses

Primary practice location

4426 Hugh Howell Rd
Ste 429
Tucker, GA 30084-4918

Mailing address

4426 Hugh Howell Rd
Ste 429
Tucker, GA 30084-4918
Phone (404) 667-9648

National Provider Directory

National Provider Directory

Locations

4426 Hugh Howell Rd
#429
Tucker, GA 30084
Phone (404) 667-9648

4426 Hugh Howell Rd
Ste 429
Tucker, GA 30084
Phone (404) 667-9648

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1003125881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 HUGH HOWELL RD",
            "address_2": "STE 429",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844918",
            "telephone_number": "404-667-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 HUGH HOWELL RD",
            "address_2": "STE 429",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844918",
            "telephone_number": "404-667-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS MED GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "DERRER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-667-9648"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "054181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.