Premier South Medical Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREMIER SOUTH MEDICAL GROUP PC

Practice address

770 Greison TRL
Suite F
Newnan, GA 30263-6408

Phone

(770) 251-4120

Fax

(770) 251-4575

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Reanna Ramkhelawan

Title

Contracting Specialist

Phone

(786) 281-2398

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Premier South Medical Group2 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.

• Premier South Medical Group, P.C.

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1528114295
  NPD tax ID

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1669916573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8750 NW 36TH ST",
            "address_2": "SUITE 300",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782425",
            "telephone_number": "786-641-5348",
            "fax_number": "305-615-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 GREISON TRL",
            "address_2": "SUITE F",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636408",
            "telephone_number": "770-251-4120",
            "fax_number": "770-251-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SOUTH MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "RAMKHELAWAN",
        "authorized_official_first_name": "REANNA",
        "authorized_official_title_or_position": "CONTRACTING SPECIALIST",
        "authorized_official_telephone_number": "786-281-2398"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003182726A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neralagadde S Prasad
• Kelly Rae Prater Whitmore, P.T.
• Kimberly Prater, FNP-C
• Patti McKinley Prater
• Premier Medical Group of Coweta 2LLC
• Megan Prevatte
• Nicole Price-Sloan
• Bryan David Price, M.D.
• Erin McLean Price, PA-C
• Sarah Rose Price, MD

• Family Medicine Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.