Organization Active NPI

Primary Care Associates of Atlanta, LLC

  • Internal Medicine Physician
  • Tucker, GA
National Provider Identifier
1922149079
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
057199 Issued in GA
Legal business name
PRIMARY CARE ASSOCIATES OF ATLANTA, LLC
Practice address
1462 Montreal Rd
Ste 201
Tucker, GA 30084-6929
Phone
(770) 414-5611
Fax
(770) 414-5612
NPI assigned
Feb 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Authorized official

Name
Stephanie Turnage, MDNPI 1245292317
Title
Owner Physician
Phone
(770) 414-5611

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 057199 GA Primary

Addresses

Primary practice location

1462 Montreal Rd
Ste 201
Tucker, GA 30084-6929

Mailing address

1462 Montreal Rd
Ste 201
Tucker, GA 30084-6929
Phone (770) 414-5611

Other identifiers 1

IdentifierTypeStateIssuer
758713451BMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1922149079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD",
            "address_2": "STE 201",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846929",
            "telephone_number": "770-414-5611",
            "fax_number": "770-414-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD",
            "address_2": "STE 201",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846929",
            "telephone_number": "770-414-5611",
            "fax_number": "770-414-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "TURNAGE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "770-414-5611",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "057199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758713451B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.