Gwinnett Hospital System TCCC LLC

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

Legal business name

GWINNETT HOSPITAL SYSTEM TCCC LLC

Practice address

631 Professional Dr Ste 450
Lawrenceville, GA 30046-3370

Phone

(770) 963-8030

NPI assigned

Apr 1, 2019

Organization subpart

Yes

Parent organization

GWINNNETT HOSPITAL SYSTEM, INC.As reported in NPPES

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

Authorized official

Name

Mr. Thomas Y McBride III

Title

Executive Vice President/Cfo

Phone

(678) 312-4308

Specialties & licenses 1

Addresses

Part of

Gwinnett Medical Center

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1972065852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-5527",
            "fax_number": "770-339-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 450",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-963-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT HOSPITAL SYSTEM TCCC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GWINNNETT HOSPITAL SYSTEM, INC.",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "678-312-4308",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwinnett Family Medicine and Geriatrics
• Gwinnett General Medicine
• Gwinnett Gynecology and Obstetrics
• Gwinnett Heart Specialists LLC
• Gwinnett Hospital System Gme, LLC
• Gwinnett Hospital System, Inc.
• Gwinnett Hospital System, Inc.
• Gwinnett Infectious Diseases PC
• Gwinnett Internal Medicine Associates LLC
• Gwinnett Medical Group, Inc

• All providers in Lawrenceville, GA
• Medical Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.