Active NPI
Peachstate Psychiatric Services, Inc.
- Psychiatric Hospital Unit
- Atlanta, GA
National Provider Identifier
1922230648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- License
- 080408LGB
- Legal business name
- PEACHSTATE PSYCHIATRIC SERVICES, INC.
- Practice address
- 1720 Peachtree St NW Ste 640
Atlanta, GA 30309-2450 - Phone
- (404) 575-4785
- NPI assigned
- Aug 13, 2009
- Last updated
- Aug 13, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dwight A. Owens, M.D.
- Title
- Owner
- Phone
- (404) 575-4785
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 080408LGB | GA | Primary |
Addresses
Primary practice location
1720 Peachtree St NW Ste 640
Atlanta, GA 30309-2450
Mailing address
1720 Peachtree St NW Ste 640
Atlanta, GA 30309-2450
Phone (404) 575-4785
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102379467 | Other | UBH/EVERCARE | |
| 7698253 | Other | GA | AETNA |
| 162363 | Other | VALUE OPTIONS | |
| 000851309A | Other | MEDICAID GBH | |
| 26BDHBD | Other | WELLCARE MEDICARE | |
| 713313717 | Other | AMERIGROUP | |
| CLARENCE5 | Medicaid | GA | |
| 158479400 | Other | OWCP | |
| 52806851 | Other | GA | BC/BS GEORGIA |
| 52806851 | Other | BC/BS PLAN LOCATOR | |
| 27868800 | Other | WELLCRE MEDICAID | |
| 278688000 | Other | MAGELLAN PERSONAL | |
| 80440600 | Other | GA | MAGELLAN GROUP |
National Provider Directory
National Provider DirectoryLocations
1720 Peachtree St NW
Ste 640
Atlanta, GA 30309
Phone (404) 575-4785
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Atlanta, GA
- NPI 1518989433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250121600000",
"number": "1922230648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 PEACHTREE ST NW STE 640",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092450",
"telephone_number": "404-575-4785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 PEACHTREE ST NW STE 640",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092450",
"telephone_number": "404-575-4785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEACHSTATE PSYCHIATRIC SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-13",
"last_updated": "2009-08-13",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "DWIGHT",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "404-575-4785",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "GA",
"license": "080408LGB",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH/EVERCARE",
"identifier": "102379467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7698253",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "162363",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GBH",
"identifier": "000851309A",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE MEDICARE",
"identifier": "26BDHBD",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "713313717",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CLARENCE5",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OWCP",
"identifier": "158479400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GEORGIA",
"identifier": "52806851",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PLAN LOCATOR",
"identifier": "52806851",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCRE MEDICAID",
"identifier": "27868800",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN PERSONAL",
"identifier": "278688000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN GROUP",
"identifier": "80440600",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
- Peach State Medical Practice, PC (Kindbody of GA Medical Practice, PC)
- Peach State Support Services LLC
- Colleen Wood Peach, N.P.
- Peachatree Cardiovascular & Thoracic Surgeons, P.a.
- Peaches Proctology LLC
- Peachtree Allergy and Asthma Clinic PC
- Peachtree and Counseling, LLC
- Peachtree Art Therapy and Counseling
- Peachtree Behavioral LLC
- Peachtree Buckhead Surgery Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.