Organization Active NPI

Northwest Georgia Family Practice Center, PC

  • General Practice Physician
  • Summerville, GA
National Provider Identifier
1689765083
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NORTHWEST GEORGIA FAMILY PRACTICE CENTER, PC
Practice address
68 Stockade Rd
Summerville, GA 30747-1900
Phone
(706) 857-5402
Fax
(706) 857-1800
NPI assigned
Sep 28, 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
Herman E. Spivey Jr., M.D.
Title
Owner
Phone
(706) 857-5402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

68 Stockade Rd
Summerville, GA 30747-1900

Mailing address

PO Box 409
Summerville, GA 30747-0409
Phone (706) 857-5402

National Provider Directory

National Provider Directory

Locations

4 Stockade Dr
Summerville, GA 30747
Phone (706) 857-5402

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689765083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307470409",
            "telephone_number": "706-857-5402",
            "fax_number": "706-857-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 STOCKADE RD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471900",
            "telephone_number": "706-857-5402",
            "fax_number": "706-857-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GEORGIA FAMILY PRACTICE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPIVEY",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-857-5402",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.