Phoenix Medical Office at College Park,llc
NPI 1396033064 · Internal Medicine Physician · College Park, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Phoenix Medical Office at College Park,llc is a Internal Medicine Physician organization in College Park, GA (NPI 1396033064).
Provider details
- NPI number
- 1396033064
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelvin Hamner, Owner/Md(678) 788-8950
- License
- 39813 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-07-15
- Last updated
- 2012-12-11
Frequently asked questions
- What is Phoenix Medical Office at College Park,llc's NPI number?
- Phoenix Medical Office at College Park,llc's National Provider Identifier (NPI) is 1396033064, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phoenix Medical Office at College Park,llc?
- Phoenix Medical Office at College Park,llc is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Phoenix Medical Office at College Park,llc located?
- Phoenix Medical Office at College Park,llc's practice location on file with NPPES is 1631 Phoenix Blvd Ste 4, College Park, GA 30349-5545.
- What is Phoenix Medical Office at College Park,llc's phone number?
- The practice phone number listed in the NPPES registry for Phoenix Medical Office at College Park,llc is (678) 788-8950.
- Does Phoenix Medical Office at College Park,llc accept Medicare?
- Phoenix Medical Office at College Park,llc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Phoenix Medical Office at College Park,llc?
- The authorized official listed on Phoenix Medical Office at College Park,llc's NPPES record is Kelvin Hamner, Owner/Md. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phoenix Medical Office at College Park,llc's NPI active?
- Yes — Phoenix Medical Office at College Park,llc's NPI (1396033064) is active in the NPPES registry as of the last update on 2012-12-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.