NPIMap

Organization Active NPI

Alpha Internal Medicine, LLC

Doing business as Alpha Internal Medicine

  • Internal Medicine Physician
  • Fayetteville, GA
National Provider Identifier
1083622849
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040693 Issued in GA
Legal business name
ALPHA INTERNAL MEDICINE, LLC
Doing business as
Alpha Internal Medicine
Practice address
745 Glynn St S
Fayetteville, GA 30214-2049
Phone
(770) 719-5490
NPI assigned
Aug 4, 2006
Last updated
Apr 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Dr. Betsy S Horton, M.D.NPI 1932153780
Title
President
Phone
(770) 719-5490

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 720353 GA
Internal Medicine Physician 207R00000X 055270 GA
Internal Medicine Physician 207R00000X 053123 GA
Internal Medicine Physician 207R00000X 047760 GA
Internal Medicine Physician 207R00000X 040693 GA Primary

Addresses

Primary practice location

745 Glynn St S
Fayetteville, GA 30214-2049

Mailing address

PO Box 142459
Fayetteville, GA 30214-6515
Phone (770) 719-5490

Other identifiers 2

IdentifierTypeStateIssuer
510368765AMedicaidGA
00753519BMedicaidGA

Other names 1

  • Alpha Internal Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000321 GA Part B Supplier - Clinic/Group Practice 2961398185 Receives reassigned benefits from 18 practitioners
Practice locations: Fayetteville, 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
11D0941884Alpha Internal Medicine745 South Glynn Street, Fayetteville, GA 30214AccreditationJun 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1083622849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142459",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146515",
            "telephone_number": "770-719-5490",
            "fax_number": "770-719-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 GLYNN ST S",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142049",
            "telephone_number": "770-719-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-719-5490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "720353",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "055270",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "053123",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "047760",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "040693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510368765A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753519B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.