NPIMap

Organization Active NPI

Alpha Family Medicine Inc

  • Primary Care Clinic/Center
  • Alpharetta, GA
National Provider Identifier
1205243458
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
71622 Issued in GA
Legal business name
ALPHA FAMILY MEDICINE INC
Practice address
480 N Main St Ste 202
Alpharetta, GA 30009-8386
Phone
(678) 619-1974
Fax
(678) 619-1975
NPI assigned
Jul 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Shyla Reddy, MDNPI 1295774305
Title
Owner
Phone
(251) 459-3233

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 71622 GA Primary

Addresses

Primary practice location

480 N Main St Ste 202
Alpharetta, GA 30009-8386

Mailing address

PO Box 1385
Alpharetta, GA 30009-1385
Phone (678) 619-1974

Other identifiers 3

IdentifierTypeStateIssuer
051518001OtherMEDICARE PROVIDER NUMBER
009932265MedicaidAL
1295774305OtherPERSONAL NPI NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140916002800 GA Part B Supplier - Clinic/Group Practice 0345469797 Receives reassigned benefits from 7 practitioners
Practice locations: Alpharetta, 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
11D2081634Alpha Family Medicine Inc480 North Main Street, Suite 202, Alpharetta, GA 30009Certificate of waiverJul 28, 2028

National Provider Directory

National Provider Directory

Locations

480 N Main St
Ste 202
Alpharetta, GA 30009
Phone (678) 433-9735

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9927/brand/1/csg/1/fhir/r4

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": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1205243458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1385",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091385",
            "telephone_number": "678-619-1974",
            "fax_number": "678-619-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N MAIN ST STE 202",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098386",
            "telephone_number": "678-619-1974",
            "fax_number": "678-619-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA FAMILY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SHYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-459-3233",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "71622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "051518001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932265",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI NUMBER",
            "identifier": "1295774305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.