NPIMap

Organization Active NPI

Medcare Phyaicians Center, LLC

  • Internal Medicine Physician
  • Hampton, GA
National Provider Identifier
1972537975
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDCARE PHYAICIANS CENTER, LLC
Practice address
2004 McDonough Rd
Suite 100
Hampton, GA 30228-3259
Phone
(678) 479-4291
Fax
(678) 479-4295
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jose L Fernandez, M.D.NPI 1487641627
Title
Ceo
Phone
(678) 479-4291

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 Primary

Addresses

Primary practice location

2004 McDonough Rd
Suite 100
Hampton, GA 30228-3259

Mailing address

1065 Jodeco Rd
Stockbridge, GA 30281-4953
Phone (678) 284-6300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972537975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 JODECO RD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814953",
            "telephone_number": "678-284-6300",
            "fax_number": "678-284-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 MCDONOUGH RD",
            "address_2": "SUITE 100",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283259",
            "telephone_number": "678-479-4291",
            "fax_number": "678-479-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCARE PHYAICIANS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-479-4291",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.