Organization Active NPI

North Georgia Rheumatology Group, PC

  • Rheumatology Physician
  • Lawrenceville, GA
National Provider Identifier
1417159344
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
NORTH GEORGIA RHEUMATOLOGY GROUP, PC
Practice address
500 Medical Center Blvd
Suite 290
Lawrenceville, GA 30046-8708
Phone
(770) 822-1090
Fax
(770) 513-9735
NPI assigned
Jun 4, 2007
Last updated
May 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Dr. Theresa Lawrence Ford, MDNPI 1619935624
Title
Physician
Phone
(770) 822-1090

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
Rheumatology Physician 207RR0500X NU Primary

Addresses

Primary practice location

500 Medical Center Blvd
Suite 290
Lawrenceville, GA 30046-8708

Mailing address

500 Medical Center Blvd
Suite 290
Lawrenceville, GA 30046-8708
Phone (770) 822-1090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000568 GA Part B Supplier - Clinic/Group Practice 3971599739 Receives reassigned benefits from 2 practitioners
Practice locations: Lawrenceville, 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
11D2102566North Georgia Rheumatology Group, PC500 Medical Center Blvd Suite 290, Lawrenceville, GA 30046Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory

Locations

600 Professional Dr
Ste 260
Lawrenceville, GA 30046
Phone (404) 822-1090

Practitioners & affiliated clinicians

Practitioners 2

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": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1417159344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "address_2": "SUITE 290",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468708",
            "telephone_number": "770-822-1090",
            "fax_number": "770-513-9735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "address_2": "SUITE 290",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468708",
            "telephone_number": "770-822-1090",
            "fax_number": "770-513-9735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA RHEUMATOLOGY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE FORD",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-822-1090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.