NPIMap

Organization Active NPI

Piedmont Athens Regional Medical Center, Inc

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1235585092
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC
Practice address
1270 Prince Ave
Ste 201
Athens, GA 30606-2762
Phone
(706) 548-2133
Fax
(706) 548-7153
NPI assigned
May 11, 2016
Last updated
Nov 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Christy Wilbanks
Title
Director Central Business Office
Phone
(706) 369-5472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1270 Prince Ave
Ste 201
Athens, GA 30606-2762

Mailing address

PO Box 161463
Atlanta, GA 30321-1463
Phone (706) 369-5474

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000481 GA Part B Supplier - Clinic/Group Practice 6800784067 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Athens, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Farris T Johnson Jr7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1235585092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161463",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303211463",
            "telephone_number": "706-369-5474",
            "fax_number": "706-369-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 PRINCE AVE",
            "address_2": "STE 201",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062762",
            "telephone_number": "706-548-2133",
            "fax_number": "706-548-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "WILBANKS",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "DIRECTOR CENTRAL BUSINESS OFFICE",
        "authorized_official_telephone_number": "706-369-5472"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.