NPIMap

Organization Active NPI

Reliance Family Care

  • Family Medicine Physician
  • McDonough, GA
National Provider Identifier
1689036949
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
053715 Issued in GA
Legal business name
RELIANCE FAMILY CARE
Practice address
345 Huntington Place CT
McDonough, GA 30253-8651
Phone
(678) 272-7280
Fax
(678) 610-6025
NPI assigned
Mar 25, 2016
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Ms. Donna Pearson, RMA,CPC
Title
Om
Phone
(770) 377-8874

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 053715 GA Primary
Non-Pharmacy Dispensing Site 332900000X 053715 GA

Addresses

Primary practice location

345 Huntington Place CT
McDonough, GA 30253-8651

Mailing address

345 Huntington Place CT
McDonough, GA 30253-8651
Phone (678) 272-7280

Other identifiers 1

IdentifierTypeStateIssuer
626586339BMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Locust Grove Family Med PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1689036949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "678-272-7280",
            "fax_number": "678-610-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "678-272-7280",
            "fax_number": "678-610-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANCE FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OM",
        "authorized_official_telephone_number": "770-377-8874",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RMA,CPC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "053715",
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "GA",
            "license": "053715",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626586339B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.