Active NPI
James Michael Petway, M.D., F.C.C.P.
- Specialist
- Cumming, GA
National Provider Identifier
1154319952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- GA021271
- Practice address
- 327 Dahlonega St
Suite 804
Cumming, GA 30040-8209 - Phone
- (770) 886-6718
- Fax
- (770) 886-6624
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | GA021271 | GA | Primary |
Addresses
Primary practice location
327 Dahlonega St
Suite 804
Cumming, GA 30040-8209
Mailing address
327 Dahlonega St
Ste 804
Cumming, GA 30040-8209
Phone (770) 886-6718
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000276438P | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA021271 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328486400000",
"number": "1154319952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 DAHLONEGA ST",
"address_2": "STE 804",
"city": "CUMMING",
"state": "GA",
"postal_code": "300408209",
"telephone_number": "770-886-6718",
"fax_number": "770-886-6624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 DAHLONEGA ST",
"address_2": "SUITE 804",
"city": "CUMMING",
"state": "GA",
"postal_code": "300408209",
"telephone_number": "770-886-6718",
"fax_number": "770-886-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETWAY",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D., F.C.C.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2012-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "GA021271",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000276438P",
"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 Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.