Organization Active NPI

North Atlanta Family Practice, LLC

  • Internal Medicine Physician
  • Cumming, GA
National Provider Identifier
1487736138
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH ATLANTA FAMILY PRACTICE, LLC
Practice address
1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017
Phone
(770) 844-0877
Fax
(770) 844-0891
NPI assigned
Oct 20, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Sohel Momin, MDNPI 1760467013
Title
Ao
Phone
(770) 844-0877

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017

Mailing address

1400 Northside Forsyth Dr Ste 240
Cumming, GA 30041-6017
Phone (770) 844-0877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051123000060 GA Part B Supplier - Clinic/Group Practice 7315967148 Receives reassigned benefits from 8 practitioners
Practice locations: Cumming, 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
11D1046802North Atlanta Family Practice1400 Northside Forsyth Dr, Cumming, GA 30041Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory

Locations

2320 Atlanta Hwy
Ste 105
Cumming, GA 30040
Phone (678) 473-0715

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1487736138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NORTHSIDE FORSYTH DR STE 240",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416017",
            "telephone_number": "770-844-0877",
            "fax_number": "770-844-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NORTHSIDE FORSYTH DR STE 240",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416017",
            "telephone_number": "770-844-0877",
            "fax_number": "770-844-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTA FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "MOMIN",
        "authorized_official_first_name": "SOHEL",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "770-844-0877",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.