Organization Active NPI

West Georgia Internal Medicine PC

  • Internal Medicine Physician
  • Carrollton, GA
National Provider Identifier
1194793307
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST GEORGIA INTERNAL MEDICINE PC
Practice address
706 Dixie St Ste 300
Carrollton, GA 30117-3890
Phone
(770) 834-6208
Fax
(770) 830-7620
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Cindy Barge
Title
Administrator
Phone
(770) 834-6208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

706 Dixie St Ste 300
Carrollton, GA 30117-3890

Mailing address

706 Dixie St Ste 300
Carrollton, GA 30117-3890
Phone (770) 834-6208

Other identifiers 1

IdentifierTypeStateIssuer
85002004GMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000820 GA Part B Supplier - Clinic/Group Practice 9133114457 Receives reassigned benefits from 7 practitioners
Practice locations: Carrollton, 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
11D0256219West Georgia Internal Medicine PC706 Dixie Street, Suite 300, Carrollton, GA 30117AccreditationAug 16, 2026

National Provider Directory

National Provider Directory

Locations

101 Doctors Dr
Carrollton, GA 30117
Phone (770) 812-8863

706 Dixie St
Ste 300
Carrollton, GA 30117
Phone (770) 834-6208

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1194793307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 300",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173890",
            "telephone_number": "770-834-6208",
            "fax_number": "770-830-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 300",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173890",
            "telephone_number": "770-834-6208",
            "fax_number": "770-830-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "BARGE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-834-6208"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002004G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.