Organization Active NPI

Buford-Norcross Primary Care, P.C.

  • Family Medicine Physician
  • Norcross, GA
National Provider Identifier
1386811149
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
043539 Issued in GA
Legal business name
BUFORD-NORCROSS PRIMARY CARE, P.C.
Practice address
777 W Peachtree St
Norcross, GA 30071-1868
Phone
(770) 246-6100
Fax
(770) 246-6142
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Christine Liqun Bao, M.D.NPI 1831175132
Title
Doctor
Phone
(770) 246-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 043539 GA Primary

Addresses

Primary practice location

777 W Peachtree St
Norcross, GA 30071-1868

Mailing address

777 W Peachtree St
Norcross, GA 30071-1868
Phone (770) 246-6100

Other identifiers 1

IdentifierTypeStateIssuer
00753728HMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000743 GA Part B Supplier - Clinic/Group Practice 9032104583 Receives reassigned benefits from 10 practitioners
Practice locations: Buford, GA; Duluth, GA; Lawrenceville, GA; Norcross, GA; Suwanee, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0962280Buford-Norcross Primary Care PC777 West Peachtree Street, Norcross, GA 30071Provider-performed microscopyJun 28, 2027

National Provider Directory

National Provider Directory

Locations

11375 Southbridge Pkwy
Ste 100
Alpharetta, GA 30022
Phone (770) 203-0618

4855 River Green Pkwy
Ste 520
Duluth, GA 30096
Phone (678) 417-1588

5555 Oakbrook Pkwy
Ste 500
Norcross, GA 30093
Phone (770) 246-6100

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1386811149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100",
            "fax_number": "770-246-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100",
            "fax_number": "770-246-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFORD-NORCROSS PRIMARY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "BAO",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "LIQUN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-246-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753728H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.

Verify at the official NPI Registry.