NPIMap

Organization Active NPI

Kaiser Permanente Internal

  • Managed Care Organization Pharmacy
  • Tucker, GA
National Provider Identifier
1205872686
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
07798 Issued in GA
Legal business name
KAISER PERMANENTE INTERNAL
Practice address
200 Cres Ctr Pkwy
Tucker, GA 30084-7047
Phone
(770) 496-3623
Fax
(770) 496-3528
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Diane Sanders Harvey
Title
Phcy Compliance MGR Ga
Phone
(404) 949-5336

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Managed Care Organization Pharmacy 3336M0003X 07798 GA Primary

Addresses

Primary practice location

200 Cres Ctr Pkwy
Tucker, GA 30084-7047

Mailing address

200 Cres Ctr Pkwy
Tucker, GA 30084-7047

Other identifiers 2

IdentifierTypeStateIssuer
1141023OtherOTHER ID NUMBER
1141023OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Georgia Neurological in3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1205872686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CRES CTR PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CRES CTR PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847047",
            "telephone_number": "770-496-3623",
            "fax_number": "770-496-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE INTERNAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "SANDERS HARVEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PHCY COMPLIANCE MGR GA",
        "authorized_official_telephone_number": "404-949-5336"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "GA",
            "license": "07798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1141023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1141023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.