Afc Physicians of Georgia, PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

AFC PHYSICIANS OF GEORGIA, PC

Practice address

1095 Woodstock Rd
Roswell, GA 30075-0000

Phone

(678) 347-2464

Fax

(678) 347-2460

NPI assigned

May 19, 2014

Organization subpart

Yes

Parent organization

AFC PHYSICIANS OF GEORGIA, PCAs reported in NPPES

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

Authorized official

Name

Mr. Randy Johansen

Title

President

Phone

(205) 421-2101

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

American Family Care2 organizations share this tax ID, including this one

Part of

American Family Care

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Afc Physicians of Georgia Primary Care, PC

  • Primary Care Clinic/Center
  • Ft. Oglethorpe, GA
  • NPI 1134506058
  NPD tax ID

Locations

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1861803371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-421-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 WOODSTOCK RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300750000",
            "telephone_number": "678-347-2464",
            "fax_number": "678-347-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICIANS OF GEORGIA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFC PHYSICIANS OF GEORGIA, PC",
        "enumeration_date": "2014-05-19",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-421-2101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN#",
            "identifier": "202G708342",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.