Dahlonega Family Medicine, LLC
Organization Active NPI Family Medicine Physician · Dahlonega, GA
NPI 1508632092 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1508632092
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DAHLONEGA FAMILY MEDICINE, LLC
- Practice address
- 59 Tipton Dr
Dahlonega, GA 30533-1603 - Phone
- (678) 780-9341
- NPI assigned
- Nov 27, 2023
- Organization subpart
- No
Authorized official
- Name
- Paul C Woody
- Title
- Owner
- Phone
- (678) 780-9341
Practitioners 1
-
Paul C Woody, DO
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2313443 | Dahlonega Family Medicine | Certificate of waiver | Oct 30, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250128002360 | GA | Part B Supplier - Clinic/Group Practice | 3971032582 |
Receives reassigned benefits from 1 practitioner Practice locations: Dahlonega, GA |
| O20250130000369 | GA | Part B Supplier - Clinic/Group Practice | 3971032582 | Practice locations: Dahlonega, GA |
National Provider Directory
Locations
59 Tipton Dr
Dahlonega, GA 30533
Phone (706) 864-4012
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
59 Tipton Dr
Dahlonega, GA 30533-1603
Mailing address
59 Tipton Dr
Dahlonega, GA 30533-1603
Other names
- Dahlonega Family Medicine
Other providers in Dahlonega, GA
- Brandon Crosby
- Crown Mountain Women'S Health
- Laura Elaine Cupp
- Dahlonega Chiropractic Clinic LLC
- Dahlonega Chiropractic Life Center
- Dahlonega Internal Medicine
- Dahlonega Pediatric & Adolescent Medicine
- Dahlonega Pediatric & Adolescent Medicine, Inc.
- Dahlonega Pediatric and Adolescent Medicine
- Dahlonega Pediatrics Rural Healthcare Clinic
All providers in Dahlonega, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.