Peachtree Immediate Care FP, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OCC010814 Issued in GA

Legal business name

PEACHTREE IMMEDIATE CARE FP, LLC

Doing business as

Peachtree Immediate Care

Practice address

1025 Veterans Memorial Hwy
Suite 720
Mableton, GA 30126-7239

Phone

(770) 732-0720

Fax

(770) 732-0730

NPI assigned

Jul 2, 2018

Last updated

Jul 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea Malik-Roe

Title

Cfo

Phone

(678) 504-6392

Specialties & licenses 1

Addresses

Other names 1

• Peachtree Immediate Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Peachtree Immediate Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Peachtree Immediate Care FP, LLC

  dba Peachtree Immediate Care

  • Family Medicine Physician
  • Lagrange, GA
  • NPI 1316433477
  NPD tax ID
• Peachtree Immediate Care FP, LLC

  dba Peachtree Immediate Care

  • Family Medicine Physician
  • Newnan, GA
  • NPI 1538655683
  NPD tax ID
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Snellville, GA
  • NPI 1649766791
  NPD tax ID
• Peachtree Immediate Care FP, LLC

  dba Peachtree Immediate Care

  • Family Medicine Physician
  • Oakwood, GA
  • NPI 1982190039
  NPD tax ID

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1023504180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W STE 201",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144538",
            "telephone_number": "678-688-9685",
            "fax_number": "770-626-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 720",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267239",
            "telephone_number": "770-732-0720",
            "fax_number": "770-732-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE IMMEDIATE CARE FP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "MALIK-ROE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-504-6392",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "OCC010814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Adele Parker, LPC
• Christopher Parks, RPH
• Fabion Andrew Parks, P006465
• Passionate People Personal Care LLC
• Hannah Patel
• Pediatric Inpatient Care Specialists, PLLC
• Joann Peopples, RN
• Perseverance Counseling, LLC
• Karina Pezini
• Millicent Phinizy, M.S., ED.S.

• Family Medicine Physician in Mableton, GA
• Providers in Mableton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.