NPIMap

Organization Active NPI

Piedmont Medical Care Corporation

  • Family Medicine Physician
  • Smyrna, GA
National Provider Identifier
1285929018
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PIEDMONT MEDICAL CARE CORPORATION
Practice address
1314 Concord Rd SE
Smyrna, GA 30080-4361
Phone
(770) 333-8889
NPI assigned
Jun 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Christy Aquino
Title
Director, Provider Enrollment
Phone
(470) 895-0214

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Primary Care Clinic/Center 261QP2300X RN130109 GA

Addresses

Primary practice location

1314 Concord Rd SE
Smyrna, GA 30080-4361

Mailing address

PO Box 102321
Atlanta, GA 30368-4361
Phone (770) 801-2500

Other identifiers 1

IdentifierTypeStateIssuer
300030651YMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Peidmont Medical Care F3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1285929018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303684361",
            "telephone_number": "770-801-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804361",
            "telephone_number": "770-333-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT MEDICAL CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "470-895-0214"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "RN130109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030651Y",
            "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 Apr 11, 2023; 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.