NPIMap

Organization Active NPI

Atlanta Center for Medicine II PC

  • Clinic/Center
  • Decatur, GA
National Provider Identifier
1669471728
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ATLANTA CENTER FOR MEDICINE II PC
Practice address
2801 N Decatur Rd
Suite 300
Decatur, GA 30033-5949
Phone
(404) 296-3111
Fax
(404) 297-7340
NPI assigned
Jul 20, 2005
Last updated
May 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Maureen Carpenter
Title
Business Office Manager
Phone
(404) 296-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2801 N Decatur Rd
Suite 300
Decatur, GA 30033-5949

Mailing address

2801 N Decatur Rd
Suite 300
Decatur, GA 30033-5949
Phone (404) 296-3111

Other identifiers 1

IdentifierTypeStateIssuer
055003002AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110816000454 GA Part B Supplier - Clinic/Group Practice 5395914949 Receives reassigned benefits from 6 practitioners
Practice locations: Decatur, GA

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
11D0259153Atlanta Center for Medicine2801 North Decatur Rd Ste 300, Decatur, GA 30033ComplianceJul 8, 2027

National Provider Directory

National Provider Directory

Locations

2801 N Decatur Rd
Ste 300
Decatur, GA 30033
Phone (404) 296-3111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIFCBA

Practitioners & affiliated clinicians

Practitioners 7

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": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1669471728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N DECATUR RD",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335949",
            "telephone_number": "404-296-3111",
            "fax_number": "404-297-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N DECATUR RD",
            "address_2": "SUITE 300",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335949",
            "telephone_number": "404-296-3111",
            "fax_number": "404-297-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA CENTER FOR MEDICINE II PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "404-296-3111"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055003002A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.