Willow Creek Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

029768 Issued in GA

Legal business name

WILLOW CREEK FAMILY MEDICINE, PC

Practice address

11685 Alpharetta Hwy
Ste 300
Roswell, GA 30076-4913

Phone

(678) 325-6611

Fax

(678) 325-6616

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Lisa M. Rosa-Re, M.D.

Title

Owner/Physician

Phone

(678) 325-6611

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Gary Steven Orris, M.D.

  • General Practice Physician
  • Cumming, GA
  • NPI 1770556276
  NPD (past)
• Michael Lamar Ruppenthal, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Greenwood, SC
  • NPI 1437131232
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1225133796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11685 ALPHARETTA HWY",
            "address_2": "STE 300",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764913",
            "telephone_number": "678-325-6611",
            "fax_number": "678-325-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11685 ALPHARETTA HWY",
            "address_2": "STE 300",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764913",
            "telephone_number": "678-325-6611",
            "fax_number": "678-325-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "ROSA-RE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "678-325-6611",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "029768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Williams, CPE
• Susan Williams, DC
• Tavernesia Williams, RBT
• Jennifer Williamson
• Allison Marissa Willis, PHARMD
• Willow Nest Chiropractic LLC
• Bonnie Kay Wilson, LMT
• Kaitlyn Marie Wilson, OTR/L
• Ryan Edward Wilson, MD
• Sidney L Wilson

• Family Medicine Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.