NPIMap

Organization Active NPI

Pophealthcare Medical Services of Ga, LLC

  • Nurse Practitioner
  • Peachtree Corners, GA
National Provider Identifier
1407340292
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
POPHEALTHCARE MEDICAL SERVICES OF GA, LLC
Practice address
2 Sun CT Ste 400
Peachtree Corners, GA 30092-2865
Phone
(615) 721-7020
Fax
(800) 266-5158
NPI assigned
Jun 15, 2018
Last updated
Feb 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Authorized official

Name
Susan Porter
Title
Credentialing Manager
Phone
(615) 630-0988

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

2 Sun CT Ste 400
Peachtree Corners, GA 30092-2865

Mailing address

113 Seaboard LN Ste 200B
Franklin, TN 37067-8282
Phone (615) 721-7024

Other names 1

  • Virginia Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1407340292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SEABOARD LN STE 200B",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678282",
            "telephone_number": "615-721-7024",
            "fax_number": "800-266-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SUN CT STE 400",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922865",
            "telephone_number": "615-721-7020",
            "fax_number": "800-266-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPHEALTHCARE MEDICAL SERVICES OF GA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "615-630-0988"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.