Organization Active NPI

Bridgemill Family Medical Associates, PC

  • Family Medicine Physician
  • Canton, GA
National Provider Identifier
1841471273
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BRIDGEMILL FAMILY MEDICAL ASSOCIATES, PC
Practice address
3755 Sixes Rd
Suite 202
Canton, GA 30114-7842
Phone
(770) 720-1880
Fax
(770) 704-7162
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Dr. William E Porter, MD
Title
President
Phone
(770) 720-1880

Specialties & licenses 1

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

Addresses

Primary practice location

3755 Sixes Rd
Suite 202
Canton, GA 30114-7842

Mailing address

3755 Sixes Rd
Suite 202
Canton, GA 30114-7842
Phone (770) 720-1880

National Provider Directory

National Provider Directory

Locations

3755 Sixes Rd
Ste 202
Canton, GA 30114
Phone (770) 720-1880

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1841471273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-720-1880",
            "fax_number": "770-704-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-720-1880",
            "fax_number": "770-704-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEMILL FAMILY MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-720-1880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.