NPIMap

Organization Active NPI

Personal Touch Medical Center, PC

  • Family Medicine Physician
  • Fairburn, GA
National Provider Identifier
1275604308
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049877 Issued in GA
Legal business name
PERSONAL TOUCH MEDICAL CENTER, PC
Practice address
277 NE Broad St
Fairburn, GA 30213-1474
Phone
(678) 778-5869
NPI assigned
Nov 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Latasha Burgess, M.D.
Title
President
Phone
(678) 778-5869

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 049877 GA Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

277 NE Broad St
Fairburn, GA 30213-1474

Mailing address

PO Box 3464
Florence, SC 29502-3464
Phone (678) 778-5869

National Provider Directory

National Provider Directory

Locations

277 NE Broad St
Fairburn, GA 30213
Phone (678) 778-5869

65 W Campbellton St
Fairburn, GA 30213
Phone (404) 964-2201

Practitioners & affiliated clinicians

Practitioners 2

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": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1275604308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3464",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023464",
            "telephone_number": "678-778-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 NE BROAD ST",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131474",
            "telephone_number": "678-778-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL TOUCH MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "LATASHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-778-5869",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049877",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.