Organization Active NPI

Cumming Family Medicine Inc

  • Family Medicine Physician
  • Cumming, GA
National Provider Identifier
1144337023
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
032759 Issued in GA
Legal business name
CUMMING FAMILY MEDICINE INC
Practice address
765 Lanier 400 Pkwy
Cumming, GA 30040-2539
Phone
(770) 205-1294
Fax
(770) 205-1783
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Dr. Jeevana Krishna, M.D.NPI 1528020575
Title
Owner
Phone
(770) 205-1274

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 032759 GA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

765 Lanier 400 Pkwy
Cumming, GA 30040-2539

Mailing address

765 Lanier 400 Pkwy
Cumming, GA 30040-2539
Phone (770) 205-1294

Other practice location 1

133 Prominence Ct Ste 230
Dawsonville, GA 30534-8936
Phone (706) 216-1500

Other identifiers 1

IdentifierTypeStateIssuer
000579961CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000464 GA Part B Supplier - Clinic/Group Practice 0244224988 Receives reassigned benefits from 6 practitioners
Practice locations: Cumming, GA; Dawsonville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2333576Cumming Family Medicine133 Prominence Court, Suite 230, Dawsonville, GA 30534Certificate of waiverNov 6, 2027
11D2333577Cumming Family Medicine Inc765 Lanier 400 Parkway, Cumming, GA 30040Certificate of waiverNov 6, 2027

National Provider Directory

National Provider Directory

Locations

2700 Abbey Ct
Ste A
Alpharetta, GA 30004

765 Lanier 400 Pkwy
Ste 100
Cumming, GA 30040

1400 Northside Forsyth Dr
Ste 210
Cumming, GA 30041
Phone (678) 288-5864

765 Lanier 400 Pkwy
Ste 400
Cumming, GA 30040

89 Long Branch Rd
Ste A7
Dahlonega, GA 30533
Phone (706) 867-4900

5614 Thompson Bridge Rd
Murrayville, GA 30564

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1144337023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 LANIER 400 PKWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402539",
            "telephone_number": "770-205-1294",
            "fax_number": "770-205-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LANIER 400 PKWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402539",
            "telephone_number": "770-205-1294",
            "fax_number": "770-205-1783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Prominence Ct Ste 230",
            "address_purpose": "LOCATION",
            "city": "Dawsonville",
            "state": "GA",
            "postal_code": "305348936",
            "country_code": "US",
            "telephone_number": "706-216-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUMMING FAMILY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "KRISHNA",
        "authorized_official_first_name": "JEEVANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-205-1274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "032759",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000579961C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.