NPIMap

Organization Active NPI

Peachtree Orthoapedic Clinic, P.a.

  • Pharmacy
  • Cumming, GA
National Provider Identifier
1982464079
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
PEACHTREE ORTHOAPEDIC CLINIC, P.A.
Practice address
2860 Ronald Reagan Blvd Ste 240
Cumming, GA 30041-6289
Phone
(404) 355-0743
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Tolan Edward Mitchell, CFO
Title
Cfo
Phone
(404) 355-0743

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary

Addresses

Primary practice location

2860 Ronald Reagan Blvd Ste 240
Cumming, GA 30041-6289

Mailing address

2860 Ronald Reagan Blvd Ste 240
Cumming, GA 30041-6289
Phone (404) 355-0743

National Provider Directory

National Provider Directory
Tax ID family
Peachtree Orthopaedic C17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

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": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1982464079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 RONALD REAGAN BLVD STE 240",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416289",
            "telephone_number": "404-355-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 RONALD REAGAN BLVD STE 240",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416289",
            "telephone_number": "404-355-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ORTHOAPEDIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TOLAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-355-0743",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.