NPIMap

Organization Active NPI

Perimeter North Family Medicine

  • Family Medicine Physician
  • Suwanee, GA
National Provider Identifier
1013100130
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
059872 Issued in GA
Legal business name
PERIMETER NORTH FAMILY MEDICINE
Practice address
4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085
Phone
(770) 623-1331
Fax
(770) 623-5674
NPI assigned
Aug 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Padmashri Komandur Srinivasa, M.D.
Title
Provider
Phone
(770) 623-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 059872 GA Primary

Addresses

Primary practice location

4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085

Mailing address

4375 Johns Creek Pkwy
Suite 320
Suwanee, GA 30024-6085
Phone (770) 623-1331

National Provider Directory

National Provider Directory
Tax ID family
Perimeter North Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1013100130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 JOHNS CREEK PKWY",
            "address_2": "SUITE 320",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246085",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 JOHNS CREEK PKWY",
            "address_2": "SUITE 320",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246085",
            "telephone_number": "770-623-1331",
            "fax_number": "770-623-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIMETER NORTH FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "SRINIVASA",
        "authorized_official_first_name": "PADMASHRI",
        "authorized_official_middle_name": "KOMANDUR",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "770-623-1331",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "059872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.