NPIMap

Organization Active NPI

Peachtree City Obstetrics and Gynecology, P.C.

  • Obstetrics & Gynecology Physician
  • Newnan, GA
National Provider Identifier
1629410154
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PEACHTREE CITY OBSTETRICS AND GYNECOLOGY, P.C.
Practice address
775 Poplar Rd.
Suite 360
Newnan, GA 30265-8304
Phone
(770) 487-9604
Fax
(678) 673-5090
NPI assigned
Jul 25, 2013
Last updated
Jul 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Dr. Rebecca D. Banks, M.D.NPI 1033208475
Title
President
Phone
(770) 487-9604

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

775 Poplar Rd.
Suite 360
Newnan, GA 30265-8304

Mailing address

775 Poplar Rd.
Suite 360
Newnan, GA 30265-8304
Phone (770) 487-9604

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2074468Peachtree City Obstetrics and Gynecology, PC775 Poplar Road, Suite #360, Newnan, GA 30265Provider-performed microscopyMar 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Peachtree City OBGYN2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

775 Poplar Rd
Ste 360
Newnan, GA 30265
Phone (770) 487-9604

Practitioners & affiliated clinicians

Practitioners 5

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": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1629410154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD.",
            "address_2": "SUITE 360",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658304",
            "telephone_number": "770-487-9604",
            "fax_number": "678-673-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD.",
            "address_2": "SUITE 360",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658304",
            "telephone_number": "770-487-9604",
            "fax_number": "678-673-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CITY OBSTETRICS AND GYNECOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-487-9604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.