Active NPI
Premise Health of Georgia Medical PC
- Primary Care Clinic/Center
- Gainesville, GA
National Provider Identifier
1306196027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- PREMISE HEALTH OF GEORGIA MEDICAL PC
- Practice address
- 584 Lanier Park Dr
Gainesville, GA 30501-2000 - Phone
- (770) 532-5685
- Fax
- (770) 532-8515
- NPI assigned
- Sep 11, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward William Schwartz
- Title
- President
- Phone
- (844) 407-7557
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
584 Lanier Park Dr
Gainesville, GA 30501-2000
Mailing address
5500 Maryland Way
Brentwood, TN 37027-7048
Phone (844) 407-7557
Other names 1
- Fieldale Farms Family Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041209000829 | GA | Part B Supplier - Clinic/Group Practice | 3274599345 |
Receives reassigned benefits from 13 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Baldwin, GA; Carrollton, GA; Gainesville, GA; Smyrna, GA; Tyrone, GA |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Multi-Specialty Clinic/Center
- Smyrna, GA
- NPI 1326789082
O20041209000829
-
- Family Medicine Physician
- Carrollton, GA
- NPI 1437213709
O20041209000829
-
- Multi-Specialty Clinic/Center
- Tyrone, GA
- NPI 1932840683
O20041209000829
-
- Family Medicine Physician
- Baldwin, GA
- NPI 1952465056
O20041209000829
-
- Family Medicine Physician
- Savannah, GA
- NPI 1407910169
O20041209000829
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2049219 | Premise Health of Georgia Medical, PC | Certificate of waiver | May 9, 2028 |
National Provider Directory
National Provider DirectoryLocations
16906 Collection Ctr Dr
Chicago, IL 60693
16906 Collection Center Dr
Chicago, IL 60693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770681600000",
"number": "1306196027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 MARYLAND WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277048",
"telephone_number": "844-407-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "584 LANIER PARK DR",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305012000",
"telephone_number": "770-532-5685",
"fax_number": "770-532-8515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMISE HEALTH OF GEORGIA MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2012-09-11",
"last_updated": "2026-02-10",
"certification_date": "2026-02-10",
"status": "A",
"authorized_official_last_name": "SCHWARTZ",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "844-407-7557"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fieldale Farms Family Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Fieldale Farms Family Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.