Family Medical Center P.C.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

058527 Issued in GA

Legal business name

FAMILY MEDICAL CENTER P.C.

Practice address

5615 Old National Hwy Ste D
College Park, GA 30349-3817

Phone

(770) 997-2900

Fax

(404) 767-7053

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sallu Mohamed Jabati, MD

Title

Ceo

Phone

(770) 997-2900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1184703779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 OLD NATIONAL HWY STE D",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493817",
            "telephone_number": "770-997-2900",
            "fax_number": "404-767-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 OLD NATIONAL HWY STE D",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493817",
            "telephone_number": "770-997-2900",
            "fax_number": "404-767-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "JABATI",
        "authorized_official_first_name": "SALLU",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-997-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "058527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "058527",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in College Park, GA
• Providers in College Park, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.