EPITOME PRIMARY CARE
NPI 1023835782
Internal Medicine in Marietta, GA
About Epitome Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EPITOME PRIMARY CARE (NPI 1023835782) is a healthcare organization registered as an internal medicine in Marietta, Georgia and active in the NPI registry since September 2024. The organization lists Kenette St-gourdin, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Epitome Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Epitome Primary Care, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Marietta, GA 30060
Marietta, GA 30060
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Epitome Primary Care's NPI number?
The NPI number for Epitome Primary Care is 1023835782. It was assigned to this organization in the NPPES registry on September 24, 2024.
Where is Epitome Primary Care located?
Epitome Primary Care is located at 631 Campbell Hill St NW Ste 200, Marietta, GA 30060. The listed phone number is (770) 727-6124.
What is Epitome Primary Care's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Epitome Primary Care enrolled in Medicare?
Yes. Epitome Primary Care is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Epitome Primary Care?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Epitome Primary Care. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Epitome Primary Care was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Epitome Primary Care · NPI 1023835782
Internal Medicine organization in Marietta, Georgia. Organization record, active in the CMS NPPES registry since September 24, 2024.
## Identity
- **NPI:** 1023835782 (Entity type: Organization)
- **Enumerated:** September 24, 2024
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Kenette St-Gourdin, OWNER
## Practice location
- **Address:** 631 CAMPBELL HILL ST NW STE 200, Marietta, GA 30060-1390
- **Phone:** (770) 727-6124
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1023835782) · Data from the CMS NPPES public registry.