Organization Active NPI

Dr. B Abraham PC

  • Family Medicine Physician
  • Snellville, GA
National Provider Identifier
1104826775
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DR. B ABRAHAM PC
Practice address
3020 Highway 124
Snellville, GA 30039-4614
Phone
(770) 978-1331
Fax
(770) 978-8580
NPI assigned
Jul 26, 2005
Last updated
Jan 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
Stephanie Breen
Title
Practice Administrator
Phone
(770) 978-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3020 Highway 124
Snellville, GA 30039-4614

Mailing address

3020 Highway 124
Snellville, GA 30039-4614
Phone (770) 978-1331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510001427 GA Part B Supplier - Clinic/Group Practice 4981693314 Receives reassigned benefits from 7 practitioners
Practice locations: Snellville, 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
11D0699165Dr B Abraham PC3020 Highway 124, Snellville, GA 30039Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

3035 Centerville Hwy
Snellville, GA 30039
Phone (770) 982-1061

3416 Highway 124
Ste D
Snellville, GA 30039
Phone (770) 978-1331

Practitioners & affiliated clinicians

Practitioners 8

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": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1104826775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HIGHWAY 124",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394614",
            "telephone_number": "770-978-1331",
            "fax_number": "770-978-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HIGHWAY 124",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394614",
            "telephone_number": "770-978-1331",
            "fax_number": "770-978-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. B ABRAHAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "BREEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-978-1331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 26, 2026; 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.