Organization Active NPI

Commerce Adult Medicine and Pediatrics

  • Family Medicine Physician
  • Commerce, GA
National Provider Identifier
1205095148
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
053614 Issued in GA
Legal business name
COMMERCE ADULT MEDICINE AND PEDIATRICS
Practice address
687 Hospital Rd
Commerce, GA 30529-1146
Phone
(706) 335-7909
NPI assigned
Jun 5, 2008
Last updated
Feb 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Dr. Adolfo Randolph Suarez, MDNPI 1104910157
Title
Owner
Phone
(706) 335-7909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 053614 GA Primary
Pediatrics Physician 208000000X 053646 GA

Addresses

Primary practice location

687 Hospital Rd
Commerce, GA 30529-1146

Mailing address

687 Hospital Rd
Commerce, GA 30529-1146
Phone (706) 335-7909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080728000151 GA Part B Supplier - Clinic/Group Practice 4880767656 Receives reassigned benefits from 1 practitioner
Practice locations: Commerce, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1205095148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 HOSPITAL RD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291146",
            "telephone_number": "706-335-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 HOSPITAL RD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291146",
            "telephone_number": "706-335-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMERCE ADULT MEDICINE AND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "SUAREZ",
        "authorized_official_first_name": "ADOLFO",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-335-7909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "053614",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "053646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.