NPIMap

Organization Active NPI

Georgia Breast Care, P.C.

  • Surgery Physician
  • Woodstock, GA
National Provider Identifier
1740305408
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
47200 Issued in GA
Legal business name
GEORGIA BREAST CARE, P.C.
Practice address
900 Towne Lake Pkwy Ste 312
Woodstock, GA 30189-1604
Phone
(678) 370-0370
Fax
(678) 370-0371
NPI assigned
Mar 20, 2007
Last updated
Apr 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Authorized official

Name
Rhonda Rouse Wachsmuth, MDNPI 1699856385
Title
President, Georgia Breast Care
Phone
(678) 370-0370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 47200 GA Primary

Addresses

Primary practice location

900 Towne Lake Pkwy Ste 312
Woodstock, GA 30189-1604

Mailing address

900 Towne Lake Pkwy Ste 312
Woodstock, GA 30189-1604
Phone (678) 370-0370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041119000097 GA Part B Supplier - Clinic/Group Practice 7214991157 Receives reassigned benefits from 2 practitioners
Practice locations: Woodstock, GA

National Provider Directory

National Provider Directory

Locations

780 Canton Rd NE
Ste 410
Marietta, GA 30060
Phone (678) 370-0370

900 Towne Lake Pkwy
Ste 312
Woodstock, GA 30189
Phone (678) 370-0370

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ICDBAA

Practitioners & affiliated clinicians

Practitioners 9

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1740305408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 312",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "678-370-0370",
            "fax_number": "678-370-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 312",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "678-370-0370",
            "fax_number": "678-370-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA BREAST CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "WACHSMUTH",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "ROUSE",
        "authorized_official_title_or_position": "PRESIDENT, GEORGIA BREAST CARE",
        "authorized_official_telephone_number": "678-370-0370",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "47200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.