NPIMap

Organization Active NPI

South Fulton Health Care Centers, Inc.

Doing business as SFMC Primary Care Services

  • Obstetrics & Gynecology Physician
  • College Park, GA
National Provider Identifier
1902965478
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SOUTH FULTON HEALTH CARE CENTERS, INC.
Doing business as
SFMC Primary Care Services
Practice address
1920 John Wesley Ave
College Park, GA 30337-3606
Phone
(404) 765-4200
Fax
(404) 762-4897
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Mr. Wesley O. James
Title
Regional Cfo, Tenet
Phone
(404) 265-5009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1920 John Wesley Ave
College Park, GA 30337-3606

Mailing address

PO Box 741660
Atlanta, GA 30374-1660
Phone (404) 765-4200

Other identifiers 2

IdentifierTypeStateIssuer
85001462GMedicaidGA
300042918-HMedicaidGA

Other names 1

  • SFMC Primary Care Services Doing business as

National Provider Directory

National Provider Directory

Locations

1955 Campbellton Rd SW
Ste I
Atlanta, GA 30311

2575 Jolly Rd
College Park, GA 30349
Phone (404) 767-8886

150 Carnegie Pl
Ste 108
Fayetteville, GA 30214
Phone (770) 460-5667

4720 Jonesboro Rd
#J
Union City, GA 30291

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1902965478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741660",
            "telephone_number": "404-765-4200",
            "fax_number": "404-762-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 JOHN WESLEY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373606",
            "telephone_number": "404-765-4200",
            "fax_number": "404-762-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FULTON HEALTH CARE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "REGIONAL CFO, TENET",
        "authorized_official_telephone_number": "404-265-5009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001462G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300042918-H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SFMC Primary Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.