Hga Villa Rica, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

40639 Issued in GA

Legal business name

HGA VILLA RICA, LLC

Practice address

129 Bankhead Hwy
Carrollton, GA 30117-3425

Phone

(770) 838-8440

NPI assigned

Apr 27, 2017

Last updated

Apr 27, 2017By 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

Vaughn S Clagette, MD

Title

Partner

Phone

(770) 838-8440

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1033644067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6084",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301540019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 BANKHEAD HWY",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173425",
            "telephone_number": "770-838-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HGA VILLA RICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "CLAGETTE",
        "authorized_official_first_name": "VAUGHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "770-838-8440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "40639",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "40639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Pollard Henderson
• Matthew Henderson, FNP-C
• Jill Hendricks, ED.S.,LPC
• Christina Henggeler, LAPC
• Chandy Henson, DPT
• Alta Colleen Hicks, RN
• Amy Hicks
• Jennifer Lynn Hicks, PHARMD
• Michele Hicks, MED
• Stephanie Hightower, B.S. PHARM

• Internal Medicine Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.