Organization Active NPI

NW Georgia Family Practice

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1053405704
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NW GEORGIA FAMILY PRACTICE
Practice address
2526 Shallowford Road
Suite C
Marietta, GA 30066
Phone
(770) 516-3500
Fax
(770) 516-3660
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Tamiko Zachery
Title
Office Manager
Phone
(770) 516-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2526 Shallowford Road
Suite C
Marietta, GA 30066

Mailing address

2513 Shallowford Rd
Building 100
Marietta, GA 30066-6809
Phone (770) 516-3500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1053405704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 SHALLOWFORD RD",
            "address_2": "BUILDING 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666809",
            "telephone_number": "770-516-3500",
            "fax_number": "770-516-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 SHALLOWFORD ROAD",
            "address_2": "SUITE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30066",
            "telephone_number": "770-516-3500",
            "fax_number": "770-516-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW GEORGIA FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "ZACHERY",
        "authorized_official_first_name": "TAMIKO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-516-3500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.