NPIMap

Organization Active NPI

Endocrine Specialists of Georgia, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Cartersville, GA
National Provider Identifier
1902407307
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINE SPECIALISTS OF GEORGIA, LLC
Practice address
40 Fox Chase
Cartersville, GA 30120-2491
Phone
(770) 382-0185
Fax
(770) 382-0247
NPI assigned
Nov 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Dr. Francisco Puentes, M.D.NPI 1114006814
Title
Physician
Phone
(770) 382-0185

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

40 Fox Chase
Cartersville, GA 30120-2491

Mailing address

PO Box 2016
Cartersville, GA 30120-1684
Phone (770) 382-0185

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL endomgr20@yahoo.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201112002918 GA Part B Supplier - Clinic/Group Practice 5799195103 Receives reassigned benefits from 1 practitioner
Practice locations: Cartersville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1902407307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2016",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301201684",
            "telephone_number": "770-382-0185",
            "fax_number": "770-382-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FOX CHASE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202491",
            "telephone_number": "770-382-0185",
            "fax_number": "770-382-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINE SPECIALISTS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "PUENTES",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-382-0185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "endomgr20@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "40 Fox Chase",
            "city": "Cartersville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301202491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.