Oak Tree Family Medicine, PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

050671 Issued in GA

Legal business name

OAK TREE FAMILY MEDICINE, PC

Practice address

6335 Hospital Pkwy
Ste 101
Johns Creek, GA 30097-1550

Phone

(770) 814-9672

Fax

(770) 814-9673

NPI assigned

Oct 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jun H Ro, M.D.NPI 1669404760

Title

President

Phone

(770) 814-9672

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Jun H. Ro, M.D.

  • Family Medicine Physician
  • Johns Creek, GA
  • NPI 1669404760
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1548413206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY STE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971550",
            "telephone_number": "770-814-9672",
            "fax_number": "770-814-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY",
            "address_2": "STE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971550",
            "telephone_number": "770-814-9672",
            "fax_number": "770-814-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "RO",
        "authorized_official_first_name": "JUN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-814-9672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "050671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.