NPIMap

Organization Active NPI

Anglyn Family Medical Center, LLC

  • Family Medicine Physician
  • McDonough, GA
National Provider Identifier
1043381361
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ANGLYN FAMILY MEDICAL CENTER, LLC
Practice address
55 Sims St
McDonough, GA 30253-2320
Phone
(770) 957-3922
Fax
(770) 957-5477
NPI assigned
Nov 10, 2006
Last updated
Jul 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Authorized official

Name
Vicki R Anglyn
Title
Office Manager
Phone
(770) 957-3922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

55 Sims St
McDonough, GA 30253-2320

Mailing address

55 Sims St
McDonough, GA 30253-2320
Phone (770) 957-3922

National Provider Directory

National Provider Directory

Locations

55 Sims St
McDonough, GA 30253
Phone (770) 957-3922

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1043381361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SIMS ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532320",
            "telephone_number": "770-957-3922",
            "fax_number": "770-957-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SIMS ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532320",
            "telephone_number": "770-957-3922",
            "fax_number": "770-957-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGLYN FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "ANGLYN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-957-3922"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.