Impact Physician Group Indiana Pulmonary Services LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

IMPACT PHYSICIAN GROUP INDIANA PULMONARY SERVICES LLC

Practice address

21 Eastbrook BND Ste 218
Peachtree City, GA 30269-1546

Phone

(678) 967-5599

NPI assigned

Jul 26, 2019

Last updated

Jul 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Miller

Title

Ceo

Phone

(678) 967-5599

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 7

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.

• Lisa Sue Jones, NP

  • Family Nurse Practitioner
  • Columbus, IN
  • NPI 1336197672
  Medicare reassignment Care Compare group NPD
• Muhammad Yasin, MD

  • Pulmonary Disease Physician
  • Louisville, KY
  • NPI 1508004094

  IN

  Medicare reassignment Care Compare group
• Jibran Durrani, MD

  • Hospitalist Physician
  • Lafayette, IN
  • NPI 1750797262
  Medicare reassignment NPD
• Taki M Rida, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1760834147
  Medicare reassignment NPD
• Kathy Zach

  • Acute Care Nurse Practitioner
  • Anderson, IN
  • NPI 1073004495
  Medicare reassignment NPD
• Zubair Khan, M.D

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1134416019
  NPD (past)
• Tricia Pryor, PA-C

  • Physician Assistant
  • Lafayette, IN
  • NPI 1205691144
  NPD (past)

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1760036925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 218",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "678-967-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EASTBROOK BND STE 218",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691546",
            "telephone_number": "678-967-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICIAN GROUP INDIANA PULMONARY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-967-5599"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Marie Hughes
• Janice L. Hunt, MS, LPC, NCC
• Grace Rachel Shalom Hunte
• Mark Frazier Hurley
• Kristin Anne Hutchinson, PHARMD.
• Impact Physician Group North Carolina LLC
• Impact Physician Group Virginia LLC
• Impact Physician Group, LLC
• In Charge Medical Professionals LLC
• Independent Physical Therapy of Ga, LLC

• Pulmonary Disease Physician in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.