Organization Active NPI

TMC Internal Medicine Associates Villa Rica

Doing business as Villa Rica Family Medicine

  • Internal Medicine Physician
  • Villa Rica, GA
National Provider Identifier
1730194457
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TMC INTERNAL MEDICINE ASSOCIATES VILLA RICA
Doing business as
Villa Rica Family Medicine
Practice address
690 Dallas Hwy
Suite 303
Villa Rica, GA 30180-1209
Phone
(770) 456-3790
Fax
(770) 456-3785
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Dale Dreiling, M.D.
Title
Senior VP
Phone
(770) 838-8038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

690 Dallas Hwy
Suite 303
Villa Rica, GA 30180-1209

Mailing address

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857

Other identifiers 1

IdentifierTypeStateIssuer
CH5396OtherGAMEDICARE ID

Other names 1

  • Villa Rica Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

705 Dallas Hwy
Ste 301B
Villa Rica, GA 30180
Phone (770) 456-3415

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1730194457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "fax_number": "770-836-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY",
            "address_2": "SUITE 303",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801209",
            "telephone_number": "770-456-3790",
            "fax_number": "770-456-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMC INTERNAL MEDICINE ASSOCIATES VILLA RICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "DREILING",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "770-838-8038",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CH5396",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Rica Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.