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Organization Active NPI

Piedmont Healthcare Inc

  • Cardiovascular Disease Physician
  • Stockbridge, GA
National Provider Identifier
1376624940
Registry record updated Jan 23, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
013307 Issued in GA
Legal business name
PIEDMONT HEALTHCARE INC
Practice address
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone
(404) 605-3368
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Naomi M Cassin
Title
Director, Provider Enrollment
Phone
(470) 271-3427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 013307 GA Primary

Addresses

Primary practice location

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085

Mailing address

PO Box 102847
Atlanta, GA 30368-2847
Phone (770) 801-2500

Other identifiers 1

IdentifierTypeStateIssuer
313138862AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000767 GA Part B Supplier - Clinic/Group Practice 3274529524 Receives reassigned benefits from 134 practitioners
Practice locations: Stockbridge, GA; Marietta, GA; Austell, GA; Atlanta, GA

All facility ownership & control disclosures 30

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rehabilitation Hospital of Phenix CityPhenix City, AL, CCN 013033 Hospital 5% Or Greater Indirect Ownership Interest (50%) Jan 1, 2021
Piedmont Macon North HospitalMacon, GA, CCN 110201 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Macon Medical CenterMacon, GA, CCN 110164 Hospital Operational/Managerial Control Aug 1, 2021
Piedmont Eastside Medical CenterSnellville, GA, CCN 110192 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Newnan Hospital, Inc.Newnan, GA, CCN 110229 Hospital Operational/Managerial Control (100%) May 5, 2006
Piedmont Macon Medical CenterMacon, GA, CCN 11T164 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Eastside Medical CenterSnellville, GA, CCN 11S192 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Eastside Medical CenterSnellville, GA, CCN 11T192 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Cartersville Medical CenterCartersville, GA, CCN 110030 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont Newton Hospital, IncCovington, GA, CCN 110018 Hospital Operational/Managerial Control (100%) Oct 1, 2015
Piedmont Athens Regional Medical Center, Inc.Athens, GA, CCN 110074 Hospital Operational/Managerial Control (100%) Oct 1, 2016
Piedmont Hospital, Inc.Atlanta, GA, CCN 110083 Hospital Operational/Managerial Control (100%) Jul 1, 1983
Piedmont Mountainside Hospital, IncJasper, GA, CCN 110225 Hospital Operational/Managerial Control Nov 6, 2007
Piedmont Fayette Hospital IncFayetteville, GA, CCN 110215 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 6, 2007
Nov 6, 2007
Piedmont Columbus Regional MidtownColumbus, GA, CCN 110064 Hospital Operational/Managerial Control (100%) Mar 1, 2018
Piedmont Augusta HospitalAugusta, GA, CCN 110028 Hospital Operational/Managerial Control Mar 1, 2022
Piedmont Columbus Regional NorthsideColumbus, GA, CCN 110200 Hospital Operational/Managerial Control (100%) Mar 1, 2018
Piedmont Henry Hospital, Inc.Stockbridge, GA, CCN 110191 Hospital Operational/Managerial Control (100%) Jan 1, 2012
Piedmont McDuffie HospitalThomson, GA, CCN 110111 Hospital Operational/Managerial Control Mar 1, 2022
Rehabilitation Hospital of AugustaAugusta, GA, CCN 113030 Hospital 5% Or Greater Indirect Ownership Interest (50%) Jul 1, 2024
Rehabilitation Hospital of NewnanNewnan, GA, CCN 113032 Hospital 5% Or Greater Indirect Ownership Interest (50%) Jun 1, 2021
Piedmont Macon Medical CenterMacon, GA, CCN 11S164 Hospital Operational/Managerial Control (100%) Aug 1, 2021
Piedmont McDuffie HospitalThomson, GA, CCN 11U111 Hospital Operational/Managerial Control Mar 1, 2022
Piedmont Rockdale Hospital, Inc.Conyers, GA, CCN 110091 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2017
Piedmont Walton Hospital IncMonroe, GA, CCN 110046 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Rehabilitation Hospital of HenryMcDonough, GA, CCN 113035 Hospital 5% Or Greater Indirect Ownership Interest (50%) Dec 1, 2021
Rehabilitation Hospital of ColumbusColumbus, GA, CCN 113036 Hospital 5% Or Greater Indirect Ownership Interest (50%) Oct 16, 2020
Rehabilitation Hospital of AtlantaAtlanta, GA, CCN 113037 Hospital 5% Or Greater Indirect Ownership Interest (50%) Oct 16, 2020
Rehabilitation Hospital of AthensAthens, GA, CCN 113038 Hospital 5% Or Greater Indirect Ownership Interest (50%) May 1, 2022
Piedmont Home HealthAthens, GA, CCN 117125 Home health agency Operational/Managerial Control (100%) Oct 1, 2016

National Provider Directory

National Provider Directory

Member organizations 39

Organizations listed as members of this organization in the National Provider Directory.

View all 39

Locations

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

1968 Peachtree Rd NW
Ste 700
Atlanta, GA 30309
Phone (404) 605-2493

3820 Medical Park Dr
Austell, GA 30106
Phone (770) 948-5409

4890 Roswell Rd
Ste 215
Sandy Springs, GA 30342
Phone (404) 845-1276

Owned or controlled facilities with NPI records 30

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 30

Practitioners 164

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1376624940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102847",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682847",
            "telephone_number": "770-801-2500",
            "fax_number": "770-803-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "404-605-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "CASSIN",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "470-271-3427"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "013307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313138862A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.