NPIMap

Organization Active NPI

Stockbridge Family Care Center

  • Primary Care Clinic/Center
  • Stockbridge, GA
National Provider Identifier
1124051636
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
053736 Issued in GA
Legal business name
STOCKBRIDGE FAMILY CARE CENTER
Practice address
1231 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-5013
Phone
(404) 207-1860
Fax
(404) 207-1864
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susana Vega
Title
Office Manager
Phone
(404) 207-1860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 053736 GA Primary

Addresses

Primary practice location

1231 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-5013

Mailing address

1231 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-5013
Phone (404) 207-1860

National Provider Directory

National Provider Directory

Locations

1231 Eagles Landing Pkwy
#A
Stockbridge, GA 30281
Phone (404) 207-1860

Practitioners & affiliated clinicians

Practitioners 2

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124051636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 EAGLES LANDING PKWY",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815013",
            "telephone_number": "404-207-1860",
            "fax_number": "404-207-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 EAGLES LANDING PKWY",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815013",
            "telephone_number": "404-207-1860",
            "fax_number": "404-207-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKBRIDGE FAMILY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "SUSANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "404-207-1860"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "053736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.