Organization Active NPI

Afc Physicians of Georgia, PC

Doing business as AFC Physicians of GA, PC

  • General Practice Physician
  • Marietta, GA
National Provider Identifier
1265879977
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AFC PHYSICIANS OF GEORGIA, PC
Doing business as
AFC Physicians of GA, PC
Practice address
3481 Ernest Barrett Parkway SW
Marietta, GA 30064-2703
Phone
(678) 348-5119
Fax
(678) 348-5120
NPI assigned
Jun 4, 2013
Last updated
Jun 12, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
AFC PHYSICIANS OF GEORGIA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Mr. Randy Johansen
Title
President
Phone
(205) 421-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X GA Primary

Addresses

Primary practice location

3481 Ernest Barrett Parkway SW
Marietta, GA 30064-2703

Mailing address

3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902

Other names 1

  • AFC Physicians of GA, PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121226000357 GA Part B Supplier - Clinic/Group Practice 0345493375 Receives reassigned benefits from 22 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chamblee, GA; Kennesaw, GA; Marietta, GA; Woodstock, GA

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
American Family Care

Practitioners & affiliated clinicians

Practitioners 1

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": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1265879977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-421-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3481 ERNEST BARRETT PARKWAY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642703",
            "telephone_number": "678-348-5119",
            "fax_number": "678-348-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICIANS OF GEORGIA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFC PHYSICIANS OF GEORGIA, PC",
        "enumeration_date": "2013-06-04",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-421-2101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFC Physicians of GA, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AFC Physicians of GA, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.