NPIMap

Organization Active NPI

Primary Care Group of West Georgia

Doing business as Pulmonary Rehab

  • Pulmonary Disease Physician
  • Dallas, GA
National Provider Identifier
1598938185
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PRIMARY CARE GROUP OF WEST GEORGIA
Doing business as
Pulmonary Rehab
Practice address
7869 Villa Rica Hwy
Dallas, GA 30157-8638
Phone
(770) 838-1570
Fax
(770) 838-1722
NPI assigned
Apr 4, 2008
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIMARY CARE GROUP OF WEST GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Mrs. Trebba Putnam, CPC MPA
Title
Administrator
Phone
(770) 838-1570

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

7869 Villa Rica Hwy
Dallas, GA 30157-8638

Mailing address

100 Professional PL
Suite 204
Carrollton, GA 30117-3874
Phone (770) 838-1570

Other names 1

  • Pulmonary Rehab Doing business as

National Provider Directory

National Provider Directory
Part of
Primary Care GRP of Wes

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1598938185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PL",
            "address_2": "SUITE 204",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173874",
            "telephone_number": "770-838-1570",
            "fax_number": "770-838-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7869 VILLA RICA HWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301578638",
            "telephone_number": "770-838-1570",
            "fax_number": "770-838-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE GROUP OF WEST GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE GROUP OF WEST GEORGIA",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "PUTNAM",
        "authorized_official_first_name": "TREBBA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-838-1570",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC MPA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pulmonary Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.