NPIMap

Organization Active NPI

Obstetrix Medical Group of Atlanta, LLC

  • Maternal & Fetal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1396970109
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
OBSTETRIX MEDICAL GROUP OF ATLANTA, LLC
Practice address
1938 Peachtree Road
Suite 303
Atlanta, GA 30309-1281
Phone
(404) 352-5119
Fax
(404) 352-5330
NPI assigned
May 22, 2009
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Mr. Jorge Del Toro, MDNPI 1609825637
Title
Secretary
Phone
(954) 384-0175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

1938 Peachtree Road
Suite 303
Atlanta, GA 30309-1281

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091028000490 GA Part B Supplier - Clinic/Group Practice 8527105253 Receives reassigned benefits from 15 practitioners
Practice locations: Austell, GA; Villa Rica, GA; Snellville, GA; Marietta, GA; Douglasville, GA; Cartersville, GA; Carrollton, GA
O20231214000529 SC Part B Supplier - Clinic/Group Practice 8527105253 Receives reassigned benefits from 3 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory
Tax ID family
Maternal Fetal Diagnostic Center of Atlanta3 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.

Locations

1938 Peachtree Rd NW
Ste 303
Atlanta, GA 30309
Phone (404) 352-5119

1700 Hospital South Dr
Ste 301
Austell, GA 30106
Phone (770) 819-9211

958 Joe Frank Harris Pkwy SE
Bldg 107
Cartersville, GA 30120

958 Joe Frank Harris Pkwy SE
Bldg 2A
Cartersville, GA 30120

699 Church St NE
Ste 320
Marietta, GA 30060
Phone (770) 819-9211

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1396970109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "844-686-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 PEACHTREE ROAD",
            "address_2": "SUITE 303",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-352-5119",
            "fax_number": "404-352-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRIX MEDICAL GROUP OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "DEL TORO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "954-384-0175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.