NPIMap

Organization Active NPI

Piedmont Specialty Hospital Billing LLC

  • Internal Medicine Physician
  • Jasper, GA
National Provider Identifier
1699290510
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PIEDMONT SPECIALTY HOSPITAL BILLING LLC
Practice address
1266 Highway 515 S
Jasper, GA 30143-4872
Phone
(770) 801-2500
Fax
(770) 803-2121
NPI assigned
Aug 11, 2017
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Mrs. Christy Aquino
Title
Director of Provider Enorllment
Phone
(470) 271-3427

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1266 Highway 515 S
Jasper, GA 30143-4872

Mailing address

PO Box 102847
Atlanta, GA 30368-2847
Phone (770) 801-2500

Other identifiers 1

IdentifierTypeStateIssuer
003202949AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180327001180 GA Part B Supplier - Clinic/Group Practice 4183986490 Receives reassigned benefits from 406 practitioners
Practice locations: Stockbridge, GA; Snellville, GA; Newnan, GA; Macon, GA; Jasper, GA; Fayetteville, GA; Conyers, GA; Coners, GA…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1968 Peachtree Rd NW
Bldg 2
Atlanta, GA 30309
Phone (404) 585-7247

2727 Paces Ferry Rd SE
Atlanta, GA 30339
Phone (404) 426-4665

Practitioners & affiliated clinicians

Practitioners 408

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.

View all 408

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1699290510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102847",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682847",
            "telephone_number": "770-801-2500",
            "fax_number": "770-803-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "770-801-2500",
            "fax_number": "770-803-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT SPECIALTY HOSPITAL BILLING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-11",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENORLLMENT",
        "authorized_official_telephone_number": "470-271-3427",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202949A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.