NPIMap

Organization Active NPI

Gwinnett Pulmonary Group Duluth

  • Non-Pharmacy Dispensing Site
  • Duluth, GA
National Provider Identifier
1740823202
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
GWINNETT PULMONARY GROUP DULUTH
Practice address
3855 Pleasant Hill Rd Ste 180
Duluth, GA 30096-8093
Phone
(770) 995-0630
NPI assigned
Oct 28, 2019
Last updated
May 18, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GWINNETT PULMONARY GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Jennifer Thomas-Roloff
Title
Practice Administrator
Phone
(678) 942-5985

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

3855 Pleasant Hill Rd Ste 180
Duluth, GA 30096-8093

Mailing address

631 Professional Dr Ste 350
Lawrenceville, GA 30046-3370
Phone (770) 995-0630

Other practice location 1

631 Professional Dr Ste 350
Lawrenceville, GA 30046-3370
Phone (770) 995-0630

Other identifiers 1

IdentifierTypeStateIssuer
555819545SAMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Michael J Sineway MD2 organizations share this tax ID, including this one
Part of
Michael J Sineway MD

Other organizations with this tax ID 1

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

Locations

631 Professional Dr
Ste 350
Lawrenceville, GA 30046
Phone (770) 995-0630

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1740823202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 350",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-995-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD STE 180",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968093",
            "telephone_number": "770-995-0630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Professional Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300463370",
            "country_code": "US",
            "telephone_number": "770-995-0630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GWINNETT PULMONARY GROUP DULUTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GWINNETT PULMONARY GROUP",
        "enumeration_date": "2019-10-28",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "THOMAS-ROLOFF",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "678-942-5985"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555819545SA",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.