Athens Diabetes and Endocrinology

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

27679 Issued in GA

Legal business name

ATHENS DIABETES AND ENDOCRINOLOGY

Practice address

3320 Old Jefferson Rd Ste 600
Athens, GA 30607-1463

Phone

(706) 549-4155

Fax

(706) 546-0036

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peter Frandsen Vandyck, MD

Title

Owner

Phone

(706) 549-4155

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1487865952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD STE 600",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071463",
            "telephone_number": "706-549-4155",
            "fax_number": "706-546-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD STE 600",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071463",
            "telephone_number": "706-549-4155",
            "fax_number": "706-546-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS DIABETES AND ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "VANDYCK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "FRANDSEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-549-4155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "27679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0384997B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Athens, GA
• Endocrinology, Diabetes & Metabolism Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.