Organization Active NPI

Paul Internal Medicine

  • Internal Medicine Physician
  • Suwanee, GA
National Provider Identifier
1073603353
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
054087 Issued in GA
Legal business name
PAUL INTERNAL MEDICINE
Practice address
4355 Johns Creek Pkwy
Suite 500
Suwanee, GA 30024-6085
Phone
(770) 623-0008
Fax
(770) 623-0009
NPI assigned
Oct 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Ranjan Paul, M.D.NPI 1447284138
Title
Physician
Phone
(770) 623-0008

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 054087 GA Primary

Addresses

Primary practice location

4355 Johns Creek Pkwy
Suite 500
Suwanee, GA 30024-6085

Mailing address

3245 Peachtree Parkway
Suite D-170
Suwanee, GA 30024-6008
Phone (770) 623-0008

Other identifiers 1

IdentifierTypeStateIssuer
801250932AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208001001 GA Part B Supplier - Clinic/Group Practice 8921059825 Receives reassigned benefits from 1 practitioner
Practice locations: Suwanee, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1035795Paul Internal Medicine Associates, LLC4355 Johns Creek Parkway, Suite 500, Suwanee, GA 30024Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory

Locations

1105 Upper Hembree Rd
Ste B
Roswell, GA 30076
Phone (770) 623-0008

3245 Peachtree Pkwy
#D170
Suwanee, GA 30024

3245 Peachtree Pkwy
Ste D170
Suwanee, GA 30024

4355 Johns Creek Pkwy
Ste 500
Suwanee, GA 30024
Phone (770) 559-3501

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAICDA

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1073603353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 PEACHTREE PARKWAY",
            "address_2": "SUITE D-170",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246008",
            "telephone_number": "770-623-0008",
            "fax_number": "770-623-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 JOHNS CREEK PKWY",
            "address_2": "SUITE 500",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246085",
            "telephone_number": "770-623-0008",
            "fax_number": "770-623-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-15",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "RANJAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-623-0008",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "801250932A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.