NPIMap

Organization Active NPI

North Fulton Ear Nose and Throat Associates, P.C.

  • Specialist
  • Roswell, GA
National Provider Identifier
1679510044
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTH FULTON EAR NOSE AND THROAT ASSOCIATES, P.C.
Practice address
2500 Hospital Blvd
Suite 450
Roswell, GA 30076-4907
Phone
(770) 343-8675
Fax
(770) 343-8773
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Raymond L Schettino, M.D.NPI 1669471413
Title
Cfo
Phone
(770) 343-8675

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2500 Hospital Blvd
Suite 450
Roswell, GA 30076-4907

Mailing address

2500 Hospital Blvd
Suite 450
Roswell, GA 30076-4907
Phone (770) 343-8675

Other identifiers 4

IdentifierTypeStateIssuer
00408548AMedicaidGA
00428293AMedicaidGA
00580104FMedicaidGA
00749229HMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000397 GA Part B Supplier - Clinic/Group Practice 8022184415 Receives reassigned benefits from 10 practitioners
Practice locations: Roswell, GA

National Provider Directory

National Provider Directory

Locations

950 Sanders Rd
Cumming, GA 30041
Phone (678) 455-6273

5445 Meridian Mark Rd
Ste 340
Sandy Springs, GA 30342
Phone (404) 785-5650

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679510044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 450",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764907",
            "telephone_number": "770-343-8675",
            "fax_number": "770-343-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 450",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764907",
            "telephone_number": "770-343-8675",
            "fax_number": "770-343-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FULTON EAR NOSE AND THROAT ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHETTINO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-343-8675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00408548A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00428293A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00580104F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00749229H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.