TARA DERMATOLOGY CENTER PC
NPI 1699892380
Clinic/Center - Medical Specialty in Stockbridge, GA

NPI Status: Active since March 26, 2007

Contact Information

191 MEDICAL BLVD
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 991-1000

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  • Organization
  • Clinic/Center
  • Medical Specialty

About TARA DERMATOLOGY CENTER PC

This page provides the complete NPI Profile along with additional information for Tara Dermatology Center Pc, a provider established in Stockbridge, Georgia operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1699892380 assigned on March 2007. The practitioner's primary taxonomy code is 261QM2500X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's former legal business name is Vincent T Peng Md Pc. The authorized official of this NPI record is Dr. Vincent Peng (Physician)

NPI
1699892380
Provider Legal Name
TARA DERMATOLOGY CENTER PC
Other Organization Name
VINCENT T PENG MD PC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
191 MEDICAL BLVD STOCKBRIDGE, GA 30281
Location Phone
(770) 991-1000
Mailing Address
191 MEDICAL BLVD STOCKBRIDGE, GA 30281
Mailing Phone
(770) 991-1000
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-26-2007
Last Update Date
03-26-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Medical Specialty

Taxonomy Code
261QM2500X
Type
Ambulatory Health Care Facilities
License State
GA
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. VINCENT PENG

Authorized Official Title
PHYSICIAN
Authorized Official Phone
(770) 991-1000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
GRP2217MEDICARE PIN (08)GA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1699892380
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
261891694316
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 8 + 9 + 1 + 6 + 9 + 4 + 3 + 1 + 6 + 24 = 80
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1699892380 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902252539DR. ASHLEE MCCORKLE-JAMIESON M.D.
Individual
Obstetrics & Gynecology191 MEDICAL BLVD
STOCKBRIDGE, GA 30281
(678) 604-4000
1922413145DR. ELISHEBA BUTTS MD
Individual
Obstetrics & Gynecology191 MEDICAL BLVD
STOCKBRIDGE, GA 30281
(678) 604-4000
1922457167 SHNIQUAL ADAMS CNM
Individual
Advanced Practice Midwife191 MEDICAL BLVD
STOCKBRIDGE, GA 30281
(678) 604-4000
1568515245 DANIEL CHRISTOPHER MCELHANNON P.A.-C
Individual
Physician Assistant191 MEDICAL BLVD
STOCKBRIDGE, GA 30281
(678) 604-5028
1558414276 ALAN MERRILL LEVY M.D.
Individual
Surgery (Vascular Surgery)191 MEDICAL BLVD
STOCKBRIDGE, GA 30281
(678) 604-5015

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699892380, enumerated in the NPI registry as an "organization" on March 26, 2007

The provider is located at 191 Medical Blvd Stockbridge, Ga 30281 and the phone number is (770) 991-1000

This medical organization specializes in Clinic/Center with taxonomy code 261QM2500X with a focus in Medical Specialty

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on March 26, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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