Sam Peng MD PC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

057232 Issued in GA

Legal business name

SAM PENG MD PC

Practice address

1622 Rivergreen BND SE
Atlanta, GA 30339-8546

Phone

(770) 587-5485

NPI assigned

Aug 10, 2009

Last updated

Aug 10, 2009By 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

Sam Q Peng, M.D.NPI 1841221769

Title

Director

Phone

(770) 820-3855

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Kennestone 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.

• Kennestone Family Medicine

  • Primary Care Clinic/Center
  • Marietta, GA
  • NPI 1891234118
  NPD tax ID

Locations

Practitioners 1

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.

• Sam Qingshuang Peng, M.D.

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1841221769
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1043442080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 RIVERGREEN BND SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303398546",
            "telephone_number": "770-587-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 RIVERGREEN BND SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303398546",
            "telephone_number": "770-587-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM PENG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-820-3855",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "057232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Jill Salzberg
• Salzinger Chiropractic Group (Chiropractic Healthcare of Buc)
• Bruce Lee Salzinger, D.C., CCSP
• Jeremy Salzman
• Sam Corley Speech LLC
• Brickson Braima Sam Jr.
• Sam's Club Optical (Sam's Club Optical 30-6643)
• Julia Surangama Samaddar, MD MPH
• Heather Ann Samady, MD
• Mehrnoosh Samaei, MD,MPH

• Geriatric Medicine (Family Medicine) Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Geriatric Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.