NPIMap

Organization Active NPI

Peach State Medical Practice, PC

Doing business as Kindbody of GA Medical Practice, PC

  • Reproductive Endocrinology Physician
  • Atlanta, GA
National Provider Identifier
1891390084
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
PEACH STATE MEDICAL PRACTICE, PC
Doing business as
Kindbody of GA Medical Practice, PC
Practice address
3005 Peachtree Rd NE
Atlanta, GA 30305-2214
Phone
(855) 563-2639
NPI assigned
Dec 3, 2020
Organization subpart
Yes
Parent organization
KBI SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Dr. Fahimeh Sasan, DONPI 1306005145
Title
Founding OBGYN
Phone
(855) 563-2639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

3005 Peachtree Rd NE
Atlanta, GA 30305-2214

Mailing address

333 S Desplaines St Ste 201
Chicago, IL 60661-5514
Phone (855) 563-2639

Other names 1

  • Kindbody of GA Medical Practice, PC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peach State Medical Practice PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

2203 S Promenade Blvd
Ste 5185
Rogers, AR 72758
Phone (479) 480-7200

1111 19th St NW
Ste 104
Washington, DC 20036
Phone (202) 301-3595

1530 Celebration Blvd
Ste 200
Celebration, FL 34747
Phone (407) 745-1669

8845 Lyra Dr
Columbus, OH 43240
Phone (380) 222-2731

100 Colorado St
Austin, TX 78701
Phone (737) 787-7806

811 Stewart St
Seattle, WA 98101
Phone (206) 736-5839

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1891390084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S DESPLAINES ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615514",
            "telephone_number": "855-563-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052214",
            "telephone_number": "855-563-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE MEDICAL PRACTICE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KBI SERVICES, INC",
        "enumeration_date": "2020-12-03",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "SASAN",
        "authorized_official_first_name": "FAHIMEH",
        "authorized_official_title_or_position": "FOUNDING OBGYN",
        "authorized_official_telephone_number": "855-563-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindbody of GA Medical Practice, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindbody of GA Medical Practice, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.