NPIMap

Organization Active NPI

Summit Macon LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
National Provider Identifier
1104875913
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
SUMMIT MACON LLC
Practice address
235 Peachtree St NE
North Tower, Suite 2100
Atlanta, GA 30303-1401
Phone
(770) 994-9326
Fax
(770) 994-4747
NPI assigned
May 9, 2006
Last updated
Sep 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Authorized official

Name
Michael Dow Bourland, MDNPI 1194885673
Title
President & Ceo
Phone
(770) 994-9326

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
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

235 Peachtree St NE
North Tower, Suite 2100
Atlanta, GA 30303-1401

Mailing address

235 Peachtree St NE
North Tower, Suite 2100
Atlanta, GA 30303-1401
Phone (770) 994-9326

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1104875913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PEACHTREE ST NE",
            "address_2": "NORTH TOWER, SUITE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031401",
            "telephone_number": "770-994-9326",
            "fax_number": "770-994-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PEACHTREE ST NE",
            "address_2": "NORTH TOWER, SUITE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031401",
            "telephone_number": "770-994-9326",
            "fax_number": "770-994-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MACON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DOW",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "770-994-9326",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.