NPIMap

Organization Active NPI

Evergreen Primary Care, PC

Doing business as Duluth Family Medical Clinic

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1821297920
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
051195 Issued in GA
Legal business name
EVERGREEN PRIMARY CARE, PC
Doing business as
Duluth Family Medical Clinic
Practice address
4855 River Green Pkwy
Suite 520
Duluth, GA 30096-8336
Phone
(678) 417-1588
Fax
(678) 417-1589
NPI assigned
Jul 17, 2007
Last updated
Jul 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Dr. Alice-Wei You, M.D.NPI 1851301907
Title
President
Phone
(678) 417-1588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 051195 GA Primary

Addresses

Primary practice location

4855 River Green Pkwy
Suite 520
Duluth, GA 30096-8336

Mailing address

4855 River Green Pkwy
Suite 520
Duluth, GA 30096-8336
Phone (678) 417-1588

Other names 1

  • Duluth Family Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1821297920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 520",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "678-417-1588",
            "fax_number": "678-417-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 520",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "678-417-1588",
            "fax_number": "678-417-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "YOU",
        "authorized_official_first_name": "ALICE-WEI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-417-1588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duluth Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.