CARDIOVASCULAR GROUP
Complete NPI Record 1689197378
Internal Medicine - Cardiovascular Disease in Lawrenceville, GA
Active since July 25, 2017
Complete NPI Dataset
This page contains the complete raw NPPES record for Cardiovascular Group (NPI 1689197378), an internal medicine organization in Lawrenceville, GA. All 32 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1689197378 Field 1/32
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/32
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/32
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: CVG PHYSICIANS GROUP, LLC Field 4/32
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: CARDIOVASCULAR GROUP Field 5/32
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/32
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 2100 RIVERSIDE PKWY STE 119B-319 Field 7/32
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: LAWRENCEVILLE Field 8/32
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: GA Field 9/32
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 300435927 Field 10/32
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/32
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 755 WALTHER RD Field 12/32
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: LAWRENCEVILLE Field 13/32
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: GA Field 14/32
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 300468725 Field 15/32
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/32
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 7709620399 Field 17/32
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 7709950533 Field 18/32
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: SANDLER Field 21/32
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: MANFRED Field 22/32
- The first name of the authorized official.
- Authorized Official Title or Position: DIRECTING MANAGER Field 23/32
- The title or position of the authorized official.
- Authorized Official Telephone Number: 7709620399 Field 24/32
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207RC0000X Field 25/32
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 26/32
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 003196217A Field 27/32
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 28/32
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: GA Field 29/32
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Organization Subpart: N Field 30/32
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Credential Text: MD Field 31/32
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
- Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP Field 32/32
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 7
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1120 Peachtree Industrial Blvd Ste 209
Location 1/7Suwanee, GA 30024-2013 · Phone (770) 962-0399 · Fax (770) 995-0533
535 Jesse Jewell Pkwy SE Ste C
Location 2/7Gainesville, GA 30501-3772 · Phone (770) 962-0399 · Fax (770) 995-0533
2108 Teron Trce Ste 100
Location 3/7Dacula, GA 30019-1666 · Phone (770) 962-0399 · Fax (770) 995-0533
1608 Tree Ln Bldg C
Location 4/7Snellville, GA 30078-2399 · Phone (770) 979-1200 · Fax (770) 978-0730
3855 Pleasant Hill Rd Ste 250
Location 5/7Duluth, GA 30096-8093 · Phone (770) 497-1413 · Fax (770) 497-1823
4745 Nelson Brogdon Blvd Ste 300
Location 6/7Buford, GA 30518-3714 · Phone (770) 962-0399 · Fax (770) 995-0533
4365 Johns Creek Pkwy Ste 450
Location 7/7Suwanee, GA 30024-6089 · Phone (770) 495-2442 · Fax (770) 495-3446
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
003196217A Medicaid
Identifier 1/1State: GA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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