NPIMap

Organization Active NPI

Correctmed Locust Grove, LLC

  • Family Medicine Physician
  • Locust Grove, GA
National Provider Identifier
1245554682
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
053123 Issued in GA
Legal business name
CORRECTMED LOCUST GROVE, LLC
Practice address
4861 Bill Gardner Pkwy
Suite 100
Locust Grove, GA 30248-3644
Phone
(770) 626-5740
Fax
(770) 626-5750
NPI assigned
Mar 14, 2010
Last updated
Sep 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Authorized official

Name
Miss Linda Faulkner, FNPNPI 1326109877
Title
Director of Operations
Phone
(770) 626-5740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 053123 GA Primary

Addresses

Primary practice location

4861 Bill Gardner Pkwy
Suite 100
Locust Grove, GA 30248-3644

Mailing address

PO Box 538502
Atlanta, GA 30353-8502
Phone (770) 626-5740

National Provider Directory

National Provider Directory

Locations

4861 Bill Gardner Pkwy
#100
Locust Grove, GA 30248
Phone (770) 626-5740

9020 Peridot Pkwy
Stockbridge, GA 30281
Phone (770) 626-5580

Practitioners & affiliated clinicians

Practitioners 8

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": "1268524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1245554682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538502",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538502",
            "telephone_number": "770-626-5740",
            "fax_number": "770-626-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4861 BILL GARDNER PKWY",
            "address_2": "SUITE 100",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483644",
            "telephone_number": "770-626-5740",
            "fax_number": "770-626-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRECTMED LOCUST GROVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-14",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "770-626-5740",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "053123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.