Organization Active NPI

Hope Clinic, Inc.

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1780803460
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOPE CLINIC, INC.
Practice address
121 Langley Dr
Lawrenceville, GA 30046-6930
Phone
(770) 685-1300
Fax
(770) 685-1311
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Dr. William B Martin, M.D.
Title
Medical Director
Phone
(770) 685-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

121 Langley Dr
Lawrenceville, GA 30046-6930

Mailing address

PO Box 1247
Lawrenceville, GA 30046-1247
Phone (770) 685-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000723 GA Part B Supplier - Clinic/Group Practice 4688657471 Receives reassigned benefits from 8 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
11D0684070Hope Clinic Inc121 Langley Drive, Lawrenceville, GA 30046Certificate of waiverDec 4, 2026

National Provider Directory

National Provider Directory

Locations

121 Langley Dr
Lawrenceville, GA 30046
Phone (770) 685-1300

318 W Pike St
Ste 402
Lawrenceville, GA 30046
Phone (678) 377-0900

Practitioners & affiliated clinicians

Practitioners 10

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1780803460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461247",
            "telephone_number": "770-685-1300",
            "fax_number": "770-685-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 LANGLEY DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466930",
            "telephone_number": "770-685-1300",
            "fax_number": "770-685-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-685-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 1, 2020; 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.