Piedmont Professional Services, LLC
NPI 1104088905ActiveOrganization· Internal Medicine, Nephrology· Stockbridge, GA
Internal Medicine, Nephrology in Stockbridge, Georgia, registered in NPPES in July 2008. The authorized official on file is Christy Aquino, Director Of Provider Enrollment. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1104088905 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 2, 2008 |
| Last updated in NPPES | Aug 10, 2021 |
| Certified by provider | Aug 10, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Nephrology Primary | 207RN0300X | — | GA |
| Family Medicine | 207Q00000X | — | — |
| Internal Medicine, Cardiovascular Disease | 207RC0000X | — | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (SC) |
|---|
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