Genesys Family Practice, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

053075 Issued in GA

Legal business name

GENESYS FAMILY PRACTICE, INC.

Practice address

120 Handley Rd
Suite 410
Tyrone, GA 30290

Phone

(770) 964-5810

Fax

(678) 364-1216

NPI assigned

Mar 22, 2007

Last updated

Aug 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ivy Yvonne Smith, MDNPI 1801991773

Title

Owner

Phone

(770) 964-5810

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Ivy Yvonne Smith, MD

  • Family Medicine Physician
  • Tyrone, GA
  • NPI 1801991773
  Authorized official Same address or phone

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1407973936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HANDLEY RD",
            "address_2": "SUITE 410",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "30290",
            "telephone_number": "770-964-5810",
            "fax_number": "678-364-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HANDLEY RD",
            "address_2": "SUITE 410",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "30290",
            "telephone_number": "770-964-5810",
            "fax_number": "678-364-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESYS FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-964-5810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "053075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407530212B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "088BRJB",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Chante' Frazier, LPC
• G. Scott Williamson O.D., P.C. (Williamson Eye Care)
• Julietta Avila Gamboa
• Peyton Garrett, MD
• Gened Psych Associates Inc
• Genesys GYN Inc
• Genesys OB/GYN, LLC
• Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy #07068)
• Georgia Dental Professionals, PC (Tyrone Family Dentistry)
• Georgia Integrative Medicine

• Family Medicine Physician in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Family Medicine Physician in Georgia

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