NPIMap

Organization Active NPI

Infectious Diseases Associates, PC

  • Infectious Disease Physician
  • Riverdale, GA
National Provider Identifier
1689881989
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
019754 Issued in GA
Legal business name
INFECTIOUS DISEASES ASSOCIATES, PC
Practice address
6285 Garden Walk Blvd
Ste a
Riverdale, GA 30274-2612
Phone
(770) 991-1500
Fax
(770) 991-9047
NPI assigned
May 17, 2007
Last updated
Jun 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Authorized official

Name
Pam Templeton
Title
Practice Administrator
Phone
(770) 991-1500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 63616 GA
Infectious Disease Physician 207RI0200X 020689 GA
Infectious Disease Physician 207RI0200X 019754 GA Primary

Addresses

Primary practice location

6285 Garden Walk Blvd
Ste a
Riverdale, GA 30274-2612

Mailing address

6285 Garden Walk Blvd
Ste a
Riverdale, GA 30274-2612
Phone (770) 991-1500

Other identifiers 3

IdentifierTypeStateIssuer
1548276603OtherGANPI
1427064583OtherGANPI
1538216338OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000853 GA Part B Supplier - Clinic/Group Practice 6002800950 Receives reassigned benefits from 4 practitioners
Practice locations: Riverdale, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1689881989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 GARDEN WALK BLVD",
            "address_2": "STE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742612",
            "telephone_number": "770-991-1500",
            "fax_number": "770-991-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6285 GARDEN WALK BLVD",
            "address_2": "STE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742612",
            "telephone_number": "770-991-1500",
            "fax_number": "770-991-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "TEMPLETON",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-991-1500"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "63616",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "020689",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "019754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548276603",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427064583",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538216338",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.