Individual provider Active NPI

Nicolas Donald Duchemin, M.D. DABFM

  • Family Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1245508480
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82008 Issued in GA
Practice address
1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone
(770) 389-3855
Fax
(770) 474-8078
NPI assigned
Dec 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 82008 GA Primary

Addresses

Primary practice location

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173

Mailing address

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone (770) 389-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170922001432 FL Practitioner - Family Practice 5799085882
I20191223001853 GA Practitioner - Family Practice 5799085882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82008GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Continucare Medical Management Inc Current Accepting new patients
Ponce Preventive Care LLC Family Medicine CurrentSince Jun 2, 2021 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Whole Family Medicine, LLC Family Medicine PastSince Jan 30, 2004 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients

Locations

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

315 W Ponce de Leon Ave
Ste 110
Decatur, GA 30030
Phone (404) 371-9673

402 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 377-9010

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1245508480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855",
            "fax_number": "770-474-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855",
            "fax_number": "770-474-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCHEMIN",
        "first_name": "NICOLAS",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D. DABFM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-02",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "82008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.