FAMILY FIRST PRIMARY CLINIC LLC
NPI 1790660504
Family Medicine in Cumming, GA
About Family First Primary Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY FIRST PRIMARY CLINIC LLC (NPI 1790660504) is a healthcare organization registered as a family medicine in Cumming, Georgia and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through October 28, 2027 and lists Mallikarjun Samala, Administrator, 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)
Family First Primary Clinic Llc 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 Family First Primary Clinic LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2333068
Family First Primary Clinic LLC · Cumming, GAFrequently 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 Family First Primary Clinic LLC's NPI number?
The NPI number for Family First Primary Clinic LLC is 1790660504. It was assigned to this organization in the NPPES registry on August 11, 2025.
Where is Family First Primary Clinic LLC located?
Family First Primary Clinic LLC is located at 920 Peachtree Pkwy Ste 110, Cumming, GA 30041. The listed phone number is (770) 800-3372.
What is Family First Primary Clinic LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Family First Primary Clinic LLC enrolled in Medicare?
Yes. Family First Primary Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Family First Primary Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Family First Primary Clinic LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Family First Primary Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2333068) is associated with this NPI, valid through October 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Family First Primary Clinic LLC was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Family First Primary Clinic Llc · NPI 1790660504
Family Medicine organization in Cumming, Georgia. Organization record, active in the CMS NPPES registry since August 11, 2025.
## Identity
- **NPI:** 1790660504 (Entity type: Organization)
- **Enumerated:** August 11, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Mallikarjun Samala, ADMINISTRATOR
## Practice location
- **Address:** 920 PEACHTREE PKWY STE 110, Cumming, GA 30041-6823
- **Phone:** (770) 800-3372 · **Fax:** (770) 406-8188
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 24, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790660504) · Data from the CMS NPPES public registry.