Phoenix Medical Office at College Park,llc
NPI 1396033064ActiveOrganization· Internal Medicine· College Park, GA
Internal Medicine in College Park, Georgia, registered in NPPES in July 2011. The authorized official on file is Kelvin Maurice Hamner, MD, Owner/Md. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1396033064 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 15, 2011 |
| Last updated in NPPES | Dec 11, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | 39813 | 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) |
|---|
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