Active NPI
CPN Network LLC
- Family Medicine Physician
- Powder Springs, GA
National Provider Identifier
1114727765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CPN NETWORK LLC
- Practice address
- 3380 Florence Rd Ste 200
Powder Springs, GA 30127-3806 - Phone
- (909) 720-4018
- NPI assigned
- Mar 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sam Awan
- Title
- Office Manager
- Phone
- (909) 720-4018
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3380 Florence Rd Ste 200
Powder Springs, GA 30127-3806
Mailing address
3380 Florence Rd Ste 200
Powder Springs, GA 30127-3806
Phone (909) 720-4018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, WI, NY, TX, CA, AL, NC, ND, GA
Enrollment records 9
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250409001978 | IN | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: West Lafayette, IN |
| O20250411000034 | WI | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Milwaukee, WI |
| O20250411001519 | NY | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Tarrytown, NY |
| O20250414001284 | TX | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Austin, TX |
| O20250416003554 | CA | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Riverside, CA |
| O20250417002230 | AL | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Birmingham, AL |
| O20250424000328 | NC | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: Raleigh, NC |
| O20250514000998 | ND | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 1 practitioner Practice locations: West Fargo, ND |
| O20250611000164 | GA | Part B Supplier - Clinic/Group Practice | 1052835246 |
Receives reassigned benefits from 2 practitioners Practice locations: Powder Springs, GA |
National Provider Directory
National Provider DirectoryLocations
505 20th St N
Ste 1220
Birmingham, AL 35203
Phone (205) 641-4979
3380 Florence Rd
Ste 200
Powder Springs, GA 30127
5900 Balcones Dr
#8320
Austin, TX 78731
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Villa Rica, GA
- NPI 1841452166
AL, CA, Family Medicine, GA, IN, NC, ND, NY, TX, WI
-
- Family Nurse Practitioner
- West Fargo, ND
- NPI 1023491909
-
- Family Nurse Practitioner
- West Fargo, ND
- NPI 1023164845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741824000000",
"number": "1114727765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 FLORENCE RD STE 200",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301273806",
"telephone_number": "909-720-4018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 FLORENCE RD STE 200",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301273806",
"telephone_number": "909-720-4018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CPN NETWORK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A",
"authorized_official_last_name": "AWAN",
"authorized_official_first_name": "SAM",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "909-720-4018"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.