Gwinnett Family Medicine and Geriatrics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

11080875 Issued in GA

Legal business name

GWINNETT FAMILY MEDICINE AND GERIATRICS

Practice address

706 Grayson Hwy
Suite 215
Lawrenceville, GA 30046-5736

Phone

(770) 316-2994

NPI assigned

Feb 8, 2016

Last updated

Feb 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wezyann Gayle, M.D.NPI 1053536177

Title

Ceo/Owner

Phone

(646) 642-1564

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13736/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• Wezyann Gayle, MD

  • Family Medicine Physician
  • Bethlehem, GA
  • NPI 1053536177
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1588022438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 GRAYSON HWY",
            "address_2": "SUITE 215",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465736",
            "telephone_number": "770-316-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 GRAYSON HWY",
            "address_2": "SUITE 215",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465736",
            "telephone_number": "770-316-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT FAMILY MEDICINE AND GERIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "GAYLE",
        "authorized_official_first_name": "WEZYANN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "646-642-1564",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "11080875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.