NPIMap

Organization Active NPI

PVC Georgia LLC

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1447130224
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PVC GEORGIA LLC
Practice address
1640 Powers Ferry Rd SE Ste 100
Marietta, GA 30067-5491
Phone
(212) 734-6621
NPI assigned
Sep 3, 2025
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Eliezer Halpert, MDNPI 1881848687
Title
Parter
Phone
(718) 514-1432

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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

1640 Powers Ferry Rd SE Ste 100
Marietta, GA 30067-5491

Mailing address

1640 Powers Ferry Rd SE Ste 100
Marietta, GA 30067-5491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251124004357 GA Part B Supplier - Clinic/Group Practice 4789176009 Receives reassigned benefits from 8 practitioners
Practice locations: Atlanta, GA; Marietta, GA

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": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1447130224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "212-734-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PVC GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "HALPERT",
        "authorized_official_first_name": "ELIEZER",
        "authorized_official_title_or_position": "PARTER",
        "authorized_official_telephone_number": "718-514-1432",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.