Atlanta Primary Care Peachtree, PC
Organization Active NPI Specialist · Newnan, GA
NPI 1477573293 · NPPES record last updated Feb 23, 2024
Key facts
- NPI
- 1477573293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- ATLANTA PRIMARY CARE PEACHTREE, PC
- Practice address
- 51 Hospital Rd
Newnan, GA 30263-1209 - Phone
- (770) 251-5540
- Fax
- (702) 251-5502
- NPI assigned
- Jul 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Andrea Bennett
- Title
- Office Manager
- Phone
- (678) 487-0556
Practitioners 14
-
Vanessa Lee, M.D.
-
Judith T Rausch, M.D.
-
Gloria J Carusi, APRN, NP-C
-
Leslie J. Johnson, FNP-C
-
Nicole Denise Knight, NP-C
-
William C Lambert, M.D.
-
Leslie Rosenblatt-Brown, PA-C
-
Lauren Schwartz, NP
-
Anita Kaur Goodrich, M.D,
-
Elizabeth Anne Jackson, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050224000219 | GA | Part B Supplier - Clinic/Group Practice | 1254384720 |
Receives reassigned benefits from 4 practitioners Practice locations: Newnan, GA; Tyrone, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
51 Hospital Rd
Newnan, GA 30263-1209
Mailing address
51 Hospital Rd
Newnan, GA 30263-1209
Phone (770) 251-5540
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0225609 | Other | GA | CIGNA |
| 52841180 | Other | GA | BCBSGA |
| 7275373G | Other | GA | AETNA |
Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.