Organization Active NPI

Internal Medicine Specialists

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1679755029
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
034236 Issued in GA
Legal business name
INTERNAL MEDICINE SPECIALISTS
Practice address
721 Wellness Way
Suite 100
Lawrenceville, GA 30045-3304
Phone
(770) 709-0900
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Dora Caulfield
Title
Office Manager
Phone
(770) 709-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 034236 GA Primary

Addresses

Primary practice location

721 Wellness Way
Suite 100
Lawrenceville, GA 30045-3304

Mailing address

721 Wellness Way
Suite 100
Lawrenceville, GA 30045-3304
Phone (770) 709-0900

National Provider Directory

National Provider Directory

Locations

603 Old Norcross Rd
#A
Lawrenceville, GA 30046
Phone (678) 407-4489

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1679755029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 WELLNESS WAY",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453304",
            "telephone_number": "770-709-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 WELLNESS WAY",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453304",
            "telephone_number": "770-709-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "CAULFIELD",
        "authorized_official_first_name": "DORA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-709-0900"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.