Organization Active NPI

Family Behavioral Center P.C.

  • Psychiatry Physician
  • Smyrna, GA
National Provider Identifier
1255486692
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
047627 Issued in GA
Legal business name
FAMILY BEHAVIORAL CENTER P.C.
Practice address
4015 S Cobb Dr SE Ste 101
Smyrna, GA 30080-6315
Phone
(770) 432-2159
Fax
(770) 432-2506
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Authorized official

Name
Mrs. Helen Chang
Title
Billing Person
Phone
(770) 952-2048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 047627 GA Primary

Addresses

Primary practice location

4015 S Cobb Dr SE Ste 101
Smyrna, GA 30080-6315

Mailing address

4480H S Cobb Dr SE Ste 228
Smyrna, GA 30080-6958
Phone (770) 432-2159

Other identifiers 2

IdentifierTypeStateIssuer
00889864CMedicaidGA
00889864DMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121119000083 GA Part B Supplier - Clinic/Group Practice 6800047937 Receives reassigned benefits from 1 practitioner
Practice locations: Smyrna, GA

National Provider Directory

National Provider Directory

Locations

109 Petrol Pt
Peachtree Cty, GA 30269
Phone (770) 432-2159

4015 S Cobb Dr SE
Ste 101
Smyrna, GA 30080
Phone (770) 432-2159

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1255486692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480H S COBB DR SE STE 228",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806958",
            "telephone_number": "770-432-2159",
            "fax_number": "770-432-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE STE 101",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806315",
            "telephone_number": "770-432-2159",
            "fax_number": "770-432-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY BEHAVIORAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "BILLING PERSON",
        "authorized_official_telephone_number": "770-952-2048",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "047627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00889864C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00889864D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.