NPIMap

Organization Active NPI

Peach State Emergency Physicians LLC

  • Emergency Medicine Physician
  • Augusta, GA
National Provider Identifier
1053170605
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PEACH STATE EMERGENCY PHYSICIANS LLC
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 722-9011
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Boykin Robinson, MDNPI 1689773723
Title
President
Phone
(404) 500-8147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

400 Galleria Pkwy SE Ste 960
Atlanta, GA 30339-5980
Phone (404) 500-8147

Other practice location 1

2460 Washington Rd
Thomson, GA 30824-6600
Phone (706) 595-1411

Other practice location 2

2260 Wrightsboro Rd
Augusta, GA 30904-4764
Phone (706) 722-9011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240516002831 GA Part B Supplier - Clinic/Group Practice 7719328038 Receives reassigned benefits from 176 practitioners
Practice locations: Augusta, GA; Thomson, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 176

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 176

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1053170605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GALLERIA PKWY SE STE 960",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395980",
            "telephone_number": "404-500-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-722-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Thomson",
            "state": "GA",
            "postal_code": "308246600",
            "country_code": "US",
            "telephone_number": "706-595-1411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2260 Wrightsboro Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309044764",
            "country_code": "US",
            "telephone_number": "706-722-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEACH STATE EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "BOYKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-500-8147",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.