NPIMap

Organization Active NPI

Community Primary Care of Georgia LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Macon, GA
National Provider Identifier
1447501689
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
COMMUNITY PRIMARY CARE OF GEORGIA LLC
Practice address
529 Bolingreen Dr
Macon, GA 31210-5303
Phone
(478) 477-1720
NPI assigned
Sep 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Charles Kemp
Title
Vice President of Operations
Phone
(404) 401-0225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

529 Bolingreen Dr
Macon, GA 31210-5303

Mailing address

4080 McGinnis Ferry Rd
Suite 804
Alpharetta, GA 30005-3948
Phone (404) 401-0225

Other names 1

  • Community Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Primary Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12 Smith Ln
Adrian, GA 31002
Phone (478) 668-3225

214 Main St
Leesburg, GA 31763
Phone (229) 759-9236

181 Oxley Dr
Lyons, GA 30436
Phone (770) 483-4480

3520 Kenneth Dr
Macon, GA 31206
Phone (478) 781-7553

529 Bolingreen Dr
Macon, GA 31210
Phone (478) 477-1720

2249 College St
Soperton, GA 30457
Phone (770) 904-3222

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1447501689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 MCGINNIS FERRY RD",
            "address_2": "SUITE 804",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053948",
            "telephone_number": "404-401-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BOLINGREEN DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105303",
            "telephone_number": "478-477-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PRIMARY CARE OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "404-401-0225"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.