Organization Active NPI

Cha OB/GYN

  • Obstetrics & Gynecology Physician
  • Duluth, GA
National Provider Identifier
1215311402
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
66463 Issued in GA
Legal business name
CHA OB/GYN
Practice address
3855 Pleasant Hill Rd
Suite 270
Duluth, GA 30096-1407
Phone
(937) 216-5707
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Ae Seon ChaNPI 1477520799
Title
President
Phone
(937) 216-5707

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
Obstetrics & Gynecology Physician 207V00000X 66463 GA Primary

Addresses

Primary practice location

3855 Pleasant Hill Rd
Suite 270
Duluth, GA 30096-1407

Mailing address

8150 St Marlo Pkwy
Duluth, GA 30097-1625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160215002183 GA Part B Supplier - Clinic/Group Practice 0648574491 Receives reassigned benefits from 1 practitioner
Practice locations: Johns Creek, GA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11795/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1215311402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 ST MARLO PKWY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 270",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "937-216-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHA OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "CHA",
        "authorized_official_first_name": "AE SEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-216-5707"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "66463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.