Board of Regents of the University System of Georgia and on Behalf....

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....

Practice address

755 Hank Aaron Dr SW
Atlanta, GA 30315-1120

Phone

(404) 413-4040

Fax

(404) 413-4041

NPI assigned

Jul 17, 2019

Organization subpart

No

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

Authorized official

Name

Jerry Rackliffe

Title

Senior VP for Finance and Admin.

Phone

(404) 413-3000

Specialties & licenses 1

Addresses

Tax ID family

Ga State University Hea2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Board of Regents of the University System of Georgia and on Behalf....

  • General Practice Physician
  • Atlanta, GA
  • NPI 1245965813
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Board of Regents of the University System of Georgia and on Behalf....

  • General Practice Physician
  • Atlanta, GA
  • NPI 1245965813
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Marie Whitmer, MD

  • General Practice Physician
  • Atlanta, GA
  • NPI 1639373426
  NPD
• Aasiyah Barr

  • Athletic Trainer
  • Atlanta, GA
  • NPI 1770371460
  NPD (past)

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1114570389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 HANK AARON DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303151120",
            "telephone_number": "404-413-4040",
            "fax_number": "404-413-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HANK AARON DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303151120",
            "telephone_number": "404-413-4040",
            "fax_number": "404-413-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA AND ON BEHALF....",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "RACKLIFFE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SENIOR VP FOR FINANCE AND ADMIN.",
        "authorized_official_telephone_number": "404-413-3000"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BNN Strategic Management, LLC
• Lauren Elizabeth Boag, PA
• Newman Kwame Boakye-Ansa, MD
• Theophilus Boakye, MD
• Catherine Boalch, RPH, PHARM.D.
• Board of Regents of the University System of Georgia and on Behalf....
• Kelly Board, APRN, NP-C
• Afua Sarpon Boaten, MD
• Adedoyin Boatin, PHARMD
• Connie Reynolds Boatman, MPA, PA-C

• Sports Medicine (Family Medicine) Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Sports Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.