Peach State Women'S Healthcare

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

025822 Issued in GA

Legal business name

PEACH STATE WOMEN'S HEALTHCARE

Practice address

906 Hampton Rd
McDonough, GA 30253-6570

Phone

(770) 898-1415

Fax

(770) 898-2887

NPI assigned

May 29, 2008

Organization subpart

No

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

Authorized official

Name

Tracy Walker

Title

Practice Administrator

Phone

(770) 898-1415

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11895/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwin Bello, M.D.

  • Obstetrics & Gynecology Physician
  • Fayetteville, GA
  • NPI 1295741379
  NPD (past)
• Patricia Reynolds, CNM, NP

  • Advanced Practice Midwife
  • McDonough, GA
  • NPI 1215062161
  NPD (past)

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1790943504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 HAMPTON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536570",
            "telephone_number": "770-898-1415",
            "fax_number": "770-898-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 HAMPTON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536570",
            "telephone_number": "770-898-1415",
            "fax_number": "770-898-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE WOMEN'S HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-898-1415"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "025822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607945A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal L Payne, LCSW
• Erica Quiterra Payne
• Jordan Jenna Payne, APRN, WHNP-BC
• Peach Family Medicine P.C.
• Peach State Caring Hands LLC
• Bernadette Pearson, PHLEBOTOMIST, CNA
• Gregory Wayne Peck, O.D.
• Pediatric Dental Studios
• Pauline Patricia Pennant
• Perfecting Hands LLC

• Obstetrics & Gynecology Physician in McDonough, GA
• Providers in McDonough, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.