Organization Active NPI

Snellville Primary Care

  • Family Medicine Physician
  • Snellville, GA
National Provider Identifier
1104033315
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
017573 Issued in GA
Legal business name
SNELLVILLE PRIMARY CARE
Practice address
1800 Tree LN
Ste 290a
Snellville, GA 30078-2016
Phone
(770) 979-1544
Fax
(770) 979-5662
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Sarah Ghayouri, M.D.NPI 1326173436
Title
Doctor - Owner
Phone
(770) 979-1544

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 017573 GA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 039109 GA

Addresses

Primary practice location

1800 Tree LN
Ste 290a
Snellville, GA 30078-2016

Mailing address

1800 Tree LN
Ste 290a
Snellville, GA 30078-2016
Phone (770) 979-1544

Other identifiers 1

IdentifierTypeStateIssuer
00623389AMedicaidGA

National Provider Directory

National Provider Directory

Locations

748 Old Norcross Rd
Ste 150
Lawrenceville, GA 30046
Phone (770) 338-5070

1800 Tree Ln
Ste 290A
Snellville, GA 30078
Phone (770) 979-1544

1800 Tree Ln
Ste 190A
Snellville, GA 30078
Phone (770) 979-1544

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104033315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 TREE LN",
            "address_2": "STE 290A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782016",
            "telephone_number": "770-979-1544",
            "fax_number": "770-979-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TREE LN",
            "address_2": "STE 290A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782016",
            "telephone_number": "770-979-1544",
            "fax_number": "770-979-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNELLVILLE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GHAYOURI",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DOCTOR - OWNER",
        "authorized_official_telephone_number": "770-979-1544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "017573",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "039109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00623389A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.