PEACHTREE CARDIOLOGY (NPI# 1447868278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447868278 |
| Entity Type | Organization |
| Organization Name | PEACHTREE CARDIOLOGY |
| Practice Address |
190 Greencastle Rd Tyrone GA 30290-2936 |
| Practice Telephone | 7704877807 |
| Practice Fax Number | 7704877619 |
| Mailing Telephone | 7704877807 |
| Mailing Fax Number | 7704877619 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | DR. ASLAM KHAN (OWNER) |
| Authorized Official Telephone | 7704877807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CLINICAL CARDIAC ELECTROPHYSIOLOGY | 86128 | 01 |
| Street Address |
190 GREENCASTLE RD |
| City | TYRONE |
| State | GA |
| Zip Code | 30290-2936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922249267 | Scott Rappe | Internal Medicine | 190 Greencastle Rd, Tyrone, GA 30290-2936 | 2009-03-17 |
| 1437675394 | Joy Theresa Blumberg | Nurse Practitioner | 190 Greencastle Rd, Tyrone, GA 30290-2936 | 2017-08-22 |
| 1326391590 | Mary Montgomery Mobley | Nurse Practitioner | 190 Greencastle Rd, Tyrone, GA 30290-2936 | 2012-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407215361 | Kaitlin Lackey | Occupational Therapist | 105 Glendalough Court, Suite H, Tyrone, GA 30290 | 2016-02-19 |
| 1114211745 | Johannes Daniel Smit | Pharmacist | 525 Valleywood Drive, Tyrone, GA 30290 | 2011-05-31 |
| 1760700199 | Georgia Integrative Medicine | Preventive Medicine | 120 Milbrook Village Drive, Suite E, Tyrone, GA 30290 | 2010-05-10 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1386884138 | Genesys Ob/gyn, LLC | Clinic/Center | 245 Greencastle Road, Tyrone, GA 30290 | 2009-03-05 |
| 1689858805 | Immediate Care Centers of Georgia, LLC | Clinic/Center | 190 Greencastle Rd., Tyrone, GA 30290 | 2007-12-24 |
| 1437212834 | Dawn M Coffman | Physician Assistant | 190 Handley Rd., Tyrone, GA 30290 | 2006-12-18 |
| 1912971805 | Jason Rex Lee | Dentist | 195 Greencastle Rd, Tyrone, GA 30290 | 2006-02-15 |
| 1053898759 | Heather Renee Ellis | Physical Therapist | 62 Carriage Oaks Dr, Tyrone, GA 30290 | 2018-07-25 |
| 1134630858 | Marjorie Yvette Elibert | Advanced Practice Midwife | 190 Handley Rd Ste A, Tyrone, GA 30290 | 2017-10-20 |
| Find all providers in zip 30290 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194252510 | Baptist Cardiology Inc | Internal Medicine | 2060 Dan Proctor Dr Ste 3300, Saint Marys, GA 31558-3894 | 2017-05-16 |
| 1639519929 | Bernard Sayed Harbieh | Internal Medicine | 2112 Lenox Park Cir Ne, Atlanta, GA 30319-5355 | 2013-07-01 |
| 1790929859 | Edward Kojo-eyiah Koomson | Internal Medicine | 425 W 3rd Ave Ste 700, Albany, GA 31701-1969 | 2009-04-20 |
| 1407099575 | Kavita Perumal Krishnasamy | Internal Medicine | 1267 Highway 54 W Ste 4100, Fayetteville, GA 30214-2112 | 2009-04-19 |
| 1306923495 | Macon Electrophysiology Associates | Internal Medicine | 639 Hemlock Str, Ste 100, Macon, GA 31201 | 2006-11-01 |
| 1902980527 | Joseph W Poku | Internal Medicine | 639 Hemlock St, Suite 100, Macon, GA 31201-6886 | 2006-10-24 |
| 1780779363 | Central Georgia Heart Center, PC | Internal Medicine | 1062 Forsyth St., Suite 1b, Macon, GA 31201 | 2006-10-03 |
| 1609820075 | Joon Ahn | Internal Medicine | 200 S Enota Dr Ne Ste 480, Gainesville, GA 30501-3473 | 2006-05-20 |
| 1821097296 | Stephen Peyton Prater | Internal Medicine | 1404 River Pl Ste 501, Braselton, GA 30517-5600 | 2005-07-19 |
| 1730662750 | Twin Arrhythmia Group, LLC | Internal Medicine | 770 Pine St Ste 200, Macon, GA 31201-7513 | 2018-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.