NPIMap

Organization Active NPI

Piedmont Ear Nose &Throat Associates PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1245305879
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
Legal business name
PIEDMONT EAR NOSE &THROAT ASSOCIATES PC
Practice address
1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605
Phone
(404) 351-5045
Fax
(404) 351-0883
NPI assigned
Nov 21, 2006
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Mrs. Tatiana Sycheva-Johnson
Title
Billing Manager
Phone
(470) 563-6468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0905X Primary

Addresses

Primary practice location

1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605

Mailing address

1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605
Phone (404) 351-5045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000298 GA Part B Supplier - Clinic/Group Practice 8527024124 Receives reassigned benefits from 19 practitioners
Practice locations: Atlanta, 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
11D1100174Piedmont Ear Nose Throat and Allergy1720 Peachtree Street Suite 200, Atlanta, GA 30309Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory

Locations

1720 Peachtree St NW
Ste 200
Atlanta, GA 30309
Phone (404) 351-5045

35 Collier Rd NW
Ste 455
Atlanta, GA 30309
Phone (248) 563-3883

5445 Meridian Mark Rd
Ste 125
Sandy Springs, GA 30342
Phone (404) 351-5045

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1245305879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE STREET",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091605",
            "telephone_number": "404-351-5045",
            "fax_number": "404-351-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE STREET",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091605",
            "telephone_number": "404-351-5045",
            "fax_number": "404-351-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT EAR NOSE &THROAT ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "SYCHEVA-JOHNSON",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "470-563-6468",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.