NPIMap

Organization Active NPI

Rockdale Physician Practices, LLC

  • Family Medicine Physician
  • Conyers, GA
National Provider Identifier
1326489089
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54898 Issued in GA
Legal business name
ROCKDALE PHYSICIAN PRACTICES, LLC
Practice address
2215 Exchange PL SE
Conyers, GA 30013-6723
Phone
(770) 992-3522
Fax
(770) 922-3662
NPI assigned
Jul 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Timothy D Vaughn
Title
Vice President
Phone
(615) 372-8505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 54898 GA Primary

Addresses

Primary practice location

2215 Exchange PL SE
Conyers, GA 30013-6723

Mailing address

PO Box 116202
Atlanta, GA 30368-6202
Phone (770) 922-0734

Other names 1

  • Premier Healthcare Alliance Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1326489089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116202",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686202",
            "telephone_number": "770-922-0734",
            "fax_number": "770-922-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 EXCHANGE PL SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136723",
            "telephone_number": "770-992-3522",
            "fax_number": "770-922-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE PHYSICIAN PRACTICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-8505"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "54898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Healthcare Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.