Active NPI
Renato Chaves Souza, MD
- Family Medicine Physician
- Fairburn, GA
National Provider Identifier
1689607269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 015826
- Practice address
- 204 Senoia Rd
Fairburn, GA 30213-1536 - Phone
- (770) 964-9759
- Fax
- (770) 964-7001
- NPI assigned
- Jul 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 015826 | GA | Primary |
Addresses
Primary practice location
204 Senoia Rd
Fairburn, GA 30213-1536
Mailing address
204 Senoia Rd
Fairburn, GA 30213-1536
Phone (770) 964-9759
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015826 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689607269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 SENOIA RD",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131536",
"telephone_number": "770-964-9759",
"fax_number": "770-964-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 SENOIA RD",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131536",
"telephone_number": "770-964-9759",
"fax_number": "770-964-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "RENATO",
"middle_name": "CHAVES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "015826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairburn, GA
- Solutions Healthcare LLC
- Soul House Transportation
- South Fulton Family Foot Care, Inc.
- Southbridge Housecalls LLC
- Southern Hospitality Transportation
- SP&As Transports LLC
- Spring Blossom Transportation LLC
- Stephanie N Stewart, LPC (LICENSED PROFES
- Jesse Mae Stone, ED., S.
- Kayla Laranza Stubbs, MS, ATC, LAT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.