Organization Active NPI

Primary Care Specialists

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1033389564
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
050559 Issued in GA
Legal business name
PRIMARY CARE SPECIALISTS
Practice address
315 Boulevard NE
Suite 310
Atlanta, GA 30312
Phone
(678) 705-2355
Fax
(678) 705-2378
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Mrs. Genise Nicole Shelton
Title
Office Manager
Phone
(678) 705-2355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 050559 GA Primary

Addresses

Primary practice location

315 Boulevard NE
Suite 310
Atlanta, GA 30312

Mailing address

315 Boulevard NE
Suite 310
Atlanta, GA 30312
Phone (678) 705-2355

Other identifiers 1

IdentifierTypeStateIssuer
000930234BMedicaidGA

National Provider Directory

National Provider Directory

Locations

315 Boulevard NE
Ste 310
Atlanta, GA 30312
Phone (678) 371-8222

315 Boulevard NE
Ste 200
Atlanta, GA 30312
Phone (404) 265-4644

315 Boulevard NE
Ste 444
Atlanta, GA 30312
Phone (404) 420-0116

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1033389564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "678-705-2355",
            "fax_number": "678-705-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "678-705-2355",
            "fax_number": "678-705-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "GENISE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-705-2355",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000930234B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.