Organization Active NPI

Family Physicians at Summer Grove

  • Family Medicine Physician
  • Newnan, GA
National Provider Identifier
1124071634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PHYSICIANS AT SUMMER GROVE
Practice address
10 Market SQ
Suite 100
Newnan, GA 30265-5613
Phone
(770) 252-3783
Fax
(770) 252-4918
NPI assigned
May 18, 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
Joycelyn Renee Holland, M.D.NPI 1013985845
Title
Owner
Phone
(770) 252-3783

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10 Market SQ
Suite 100
Newnan, GA 30265-5613

Mailing address

10 Market SQ
Suite 100
Newnan, GA 30265-5613
Phone (770) 252-3783

National Provider Directory

National Provider Directory

Locations

42 Market Square Rd
#B
Newnan, GA 30265
Phone (404) 663-2377

10 Market Square Way
Ste 100
Newnan, GA 30265
Phone (770) 252-3783

Practitioners & affiliated clinicians

Practitioners 1

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124071634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARKET SQ",
            "address_2": "SUITE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655613",
            "telephone_number": "770-252-3783",
            "fax_number": "770-252-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARKET SQ",
            "address_2": "SUITE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655613",
            "telephone_number": "770-252-3783",
            "fax_number": "770-252-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHYSICIANS AT SUMMER GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JOYCELYN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-252-3783",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, 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.