NPIMap

Organization Active NPI

Piedmont Athens Regional Medical Center, Inc.

Doing business as Piedmont Home Infusion

  • Home Infusion Agency
  • Athens, GA
National Provider Identifier
1003801184
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
PHRE008281 Issued in GA
Legal business name
PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.
Doing business as
Piedmont Home Infusion
Practice address
1510 Prince Ave
Athens, GA 30606-6006
Phone
(706) 475-5500
Fax
(706) 475-5570
NPI assigned
Sep 15, 2005
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Wendy Johnson Cook
Title
Cfo
Phone
(706) 475-5563

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X PHRE008281 GA Primary
Home Infusion Therapy Pharmacy 3336H0001X NU

Addresses

Primary practice location

1510 Prince Ave
Athens, GA 30606-6006

Mailing address

1510 Prince Ave
Athens, GA 30606-6006
Phone (706) 475-5563

Other identifiers 1

IdentifierTypeStateIssuer
00801798BMedicaidGA

Other names 1

  • Piedmont Home Infusion Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930066221 GA DME Supplier - PharmacyDME Supplier - Home Health AgencyDME Supplier - Medical Supply Company With Registered Pharmacist 6800784067 Practice locations: Athens, GA
O20230306001984 GA Part B Supplier - Home Infusion Therapy Supplier 6800784067 Practice locations: Athens, GA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1199 Prince Ave
Fl First
Athens, GA 30606
Phone (706) 475-1920

1510 Prince Ave
Athens, GA 30606
Phone (706) 475-5500

3320 Old Jefferson Rd
Ste 200C
Athens, GA 30607
Phone (706) 475-6881

930 Franklin Springs St
Ste C
Royston, GA 30662
Phone (706) 246-9729

930 Franklin Springs St
Ste D
Royston, GA 30662

1305 Jennings Mill Rd
Ste 130
Watkinsville, GA 30677
Phone (706) 475-6881

1305 Jennings Mill Rd
Ste 160
Watkinsville, GA 30677
Phone (706) 552-1960

1305 Jennings Mill Rd
Ste 170
Watkinsville, GA 30677
Phone (706) 552-1920

1305 Jennings Mill Rd
Ste 280
Watkinsville, GA 30677
Phone (706) 552-1821

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1003801184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066006",
            "telephone_number": "706-475-5563",
            "fax_number": "706-475-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066006",
            "telephone_number": "706-475-5500",
            "fax_number": "706-475-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-475-5563"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "GA",
            "license": "PHRE008281",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00801798B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Home Infusion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piedmont Home Infusion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.