NPIMap

Organization Active NPI

The Family Health Centers of Georgia, Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
National Provider Identifier
1760612055
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Practice address
2011 Bolton Road
Suite 104
Atlanta, GA 30318-1137
Phone
(404) 799-0851
Fax
(404) 794-4798
NPI assigned
Jul 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Michael W Brooks, MD
Title
President, Ceo
Phone
(404) 752-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2011 Bolton Road
Suite 104
Atlanta, GA 30318-1137

Mailing address

2011 Bolton Road
Suite 104
Atlanta, GA 30318-1137
Phone (404) 799-0851

Other identifiers 1

IdentifierTypeStateIssuer
000437478MMedicaidGA

Other names 1

  • The Family Health Center@ Bolton Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000807 GA Part B Supplier - Clinic/Group Practice 2062406903 Receives reassigned benefits from 38 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rome, GA; Morrow, GA; Atlanta, GA; Marietta, GA; Douglasville, GA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1760612055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 BOLTON ROAD",
            "address_2": "SUITE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303181137",
            "telephone_number": "404-799-0851",
            "fax_number": "404-794-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BOLTON ROAD",
            "address_2": "SUITE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303181137",
            "telephone_number": "404-799-0851",
            "fax_number": "404-794-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY HEALTH CENTERS OF GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "404-752-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000437478M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Health Center@ Bolton Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.