Organization Active NPI

SK Drews, Inc

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1760680763
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049899 Issued in GA
Legal business name
SK DREWS, INC
Practice address
3496 Club Dr
Lawrenceville, GA 30044-3021
Phone
(770) 248-9345
Fax
(770) 797-9615
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Authorized official

Name
Jennifer Vo, MD
Title
Manager
Phone
(770) 248-9345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 049899 GA Primary

Addresses

Primary practice location

3496 Club Dr
Lawrenceville, GA 30044-3021

Mailing address

3496 Club Dr
Lawrenceville, GA 30044-3021
Phone (770) 248-9345

Other identifiers 4

IdentifierTypeStateIssuer
1760680763MedicaidGA
894388589AMedicaidGA
1477607737MedicaidGA
1629192026MedicaidGA

Other names 1

  • Drews Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914000649 GA Part B Supplier - Clinic/Group Practice 6608843172 Receives reassigned benefits from 3 practitioners
Practice locations: Lawrenceville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1021668Drews Family Medicine3496 Club Drive, Lawrenceville, GA 30044Certificate of waiverMar 27, 2028

National Provider Directory

National Provider Directory

Locations

3496 Club Dr
Lawrenceville, GA 30044
Phone (770) 248-9345

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1760680763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3496 CLUB DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443021",
            "telephone_number": "770-248-9345",
            "fax_number": "770-797-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3496 CLUB DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443021",
            "telephone_number": "770-248-9345",
            "fax_number": "770-797-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SK DREWS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-248-9345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760680763",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894388589A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477607737",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629192026",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drews Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.