NPIMap

Organization Active NPI

Northwest Georgia Oncology Centers, PC

  • Durable Medical Equipment & Medical Supplies
  • Bremen, GA
National Provider Identifier
1700914926
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
074178000 Issued in GA
Legal business name
NORTHWEST GEORGIA ONCOLOGY CENTERS, PC
Practice address
200 Allen Memorial Dr
Ste 302-B
Bremen, GA 30110-2012
Phone
(770) 824-2222
Fax
(770) 824-2426
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Dr. Bruce J. Gould, MD
Title
MD Physician
Phone
(770) 281-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 074178000 GA Primary

Addresses

Primary practice location

200 Allen Memorial Dr
Ste 302-B
Bremen, GA 30110-2012

Mailing address

1700 Hospital South Dr
Suite 200
Austell, GA 30106-6810
Phone (770) 944-2830

Other identifiers 1

IdentifierTypeStateIssuer
1700914926OtherGASUPPLIER NPI NUMBER (BREMEN)

National Provider Directory

National Provider Directory
Tax ID family
Northwest Georgia Oncol5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1700 Hospital South Dr
Ste 200
Austell, GA 30106
Phone (770) 944-7818

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1700914926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066810",
            "telephone_number": "770-944-2830",
            "fax_number": "678-581-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ALLEN MEMORIAL DR",
            "address_2": "STE 302-B",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102012",
            "telephone_number": "770-824-2222",
            "fax_number": "770-824-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GEORGIA ONCOLOGY CENTERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MD PHYSICIAN",
        "authorized_official_telephone_number": "770-281-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "074178000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER NPI NUMBER (BREMEN)",
            "identifier": "1700914926",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.