NPIMap

Organization Active NPI

Peachtree Women's Clinic 2 LLC

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1174653877
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PEACHTREE WOMEN'S CLINIC 2 LLC
Practice address
5780 Peachtree Dunwoody Rd NE
Suite 200
Atlanta, GA 30342-1554
Phone
(404) 943-0205
NPI assigned
Mar 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Alicia Holden, ACCOUNTING
Title
Lead
Phone
(404) 943-0205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

5780 Peachtree Dunwoody Rd NE
Suite 200
Atlanta, GA 30342-1554

Mailing address

PO Box 468329
Atlanta, GA 31146-8329
Phone (404) 943-0205

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
11D0679601Peachtree Women's Clinic5780 Peachtree Dunwoody Rd, Suite 200, Atlanta, GA 30342Provider-performed microscopyMay 4, 2027

National Provider Directory

National Provider Directory

Locations

1110 W Peachtree St NW
Ste 810
Atlanta, GA 30309
Phone (404) 300-2990

460 Northside Cherokee Blvd
Ste 360
Canton, GA 30115
Phone (678) 891-6541

1505 Northside Blvd
Ste 2400
Cumming, GA 30041
Phone (770) 292-3490

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174653877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468329",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311468329",
            "telephone_number": "404-943-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421554",
            "telephone_number": "404-943-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE WOMEN'S CLINIC 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "LEAD",
        "authorized_official_telephone_number": "404-943-0205",
        "authorized_official_credential": "ACCOUNTING"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, 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.
  • 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.