NPIMap

Organization Active NPI

Acworth Family Medicine, PC

  • Primary Care Clinic/Center
  • Kennesaw, GA
National Provider Identifier
1285786541
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
040714 Issued in GA
Legal business name
ACWORTH FAMILY MEDICINE, PC
Practice address
5150 Stilesboro Rd NW
Suite 120
Kennesaw, GA 30152-7744
Phone
(678) 354-0230
Fax
(678) 354-0828
NPI assigned
Jan 17, 2007
Last updated
Sep 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Authorized official

Name
Dr. Daniel J Kuzio, M.D.NPI 1851475396
Title
Owner
Phone
(678) 354-0230

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
Primary Care Clinic/Center 261QP2300X 040714 GA Primary

Addresses

Primary practice location

5150 Stilesboro Rd NW
Suite 120
Kennesaw, GA 30152-7744

Mailing address

5150 Stilesboro Rd NW
Suite 120
Kennesaw, GA 30152-7744
Phone (678) 354-0230

Other identifiers 4

IdentifierTypeStateIssuer
1775856OtherGAUNITED HEALTHCARE
759253OtherGABLUECROSS BLUESHIELD GA
160227OtherGACOVENTRY HEALTHCARE OF GA
9289602OtherGACIGNA HEALTHCARE

National Provider Directory

National Provider Directory

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1285786541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 STILESBORO RD NW",
            "address_2": "SUITE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527744",
            "telephone_number": "678-354-0230",
            "fax_number": "678-354-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 STILESBORO RD NW",
            "address_2": "SUITE 120",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527744",
            "telephone_number": "678-354-0230",
            "fax_number": "678-354-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACWORTH FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "KUZIO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-354-0230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "040714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1775856",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD GA",
            "identifier": "759253",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE OF GA",
            "identifier": "160227",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "9289602",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.