Organization Active NPI

Piedmont Athens Specialty Care LLC

  • Cardiovascular Disease Physician
  • Athens, GA
National Provider Identifier
1184130627
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PIEDMONT ATHENS SPECIALTY CARE LLC
Practice address
1199 Prince Ave
Athens, GA 30606-2797
Phone
(706) 475-7000
NPI assigned
Dec 20, 2017
Last updated
Aug 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Authorized official

Name
Mrs. Christy Aquino
Title
Director of Provider Enrollment
Phone
(470) 271-3427

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

1199 Prince Ave
Athens, GA 30606-2797

Mailing address

PO Box 117265
Atlanta, GA 30368-7264
Phone (706) 475-7000

Other identifiers 1

IdentifierTypeStateIssuer
003208695AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180917001273 GA Part B Supplier - Clinic/Group Practice 8820349772 Receives reassigned benefits from 176 practitioners
Practice locations: Covington, GA; Eatonton, GA; Elberton, GA; Greensboro, GA; Jefferson, GA; Madison, GA; Monroe, GA; Athens, GA…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1 Selig Cir
Athens, GA 30602
Phone (706) 542-6521

100 Smith St
Athens, GA 30602
Phone (706) 542-6521

1270 Prince Ave
Ste 303
Athens, GA 30606
Phone (706) 543-8172

1500 Oglethorpe Ave
Ste 500B
Athens, GA 30606
Phone (706) 548-5833

1500 Oglethorpe Ave
Ste 600CD
Athens, GA 30606
Phone (706) 546-5191

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

1301 Sigman Rd NE
Ste 280
Conyers, GA 30012
Phone (678) 413-6276

1412 Milstead Ave NE
Ste 100
Conyers, GA 30012
Phone (770) 483-9330

9202 Highway 278 NE
Ste 100E
Covington, GA 30014
Phone (678) 342-8671

1077 S Main St
Ste 200
Madison, GA 30650
Phone (770) 264-0978

2151 W Spring St
Ste 110
Monroe, GA 30655
Phone (770) 267-1895

2151 W Spring St
Ste B140
Monroe, GA 30655
Phone (678) 214-6118

795 Poplar Rd
Ste 400
Newnan, GA 30265
Phone (770) 254-6089

1305 Jennings Mill Rd
Ste 110
Watkinsville, GA 30677
Phone (706) 613-5880

1305 Jennings Mill Rd
Ste 250
Watkinsville, GA 30677

1305 Jennings Mill Rd
Ste 260
Watkinsville, GA 30677
Phone (706) 548-0008

1305 Jennings Mill Rd
Ste 290A
Watkinsville, GA 30677
Phone (706) 552-1840

1305 Jennings Mill Rd
Ste 290B
Watkinsville, GA 30677
Phone (706) 552-1730

Practitioners & affiliated clinicians

Practitioners 640

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 640

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1184130627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117265",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687264",
            "telephone_number": "706-475-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062797",
            "telephone_number": "706-475-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ATHENS SPECIALTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "470-271-3427",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208695A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.