NPIMap

Organization Active NPI

Ideal Gynecology 2, LLC

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1003343963
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
40540 Issued in GA
Legal business name
IDEAL GYNECOLOGY 2, LLC
Practice address
3200 Downwood Cir NW Ste 220
Atlanta, GA 30327-1611
Phone
(470) 312-3696
Fax
(866) 278-2622
NPI assigned
May 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelley Depp
Title
Payer Relations Liaison
Phone
(770) 579-2626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 40540 GA Primary

Addresses

Primary practice location

3200 Downwood Cir NW Ste 220
Atlanta, GA 30327-1611

Mailing address

PO Box 468329
Atlanta, GA 31146-8329
Phone (404) 943-0205

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495411200000",
    "number": "1003343963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468329",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311468329",
            "telephone_number": "404-943-0205",
            "fax_number": "404-943-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 DOWNWOOD CIR NW STE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271611",
            "telephone_number": "470-312-3696",
            "fax_number": "866-278-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL GYNECOLOGY 2, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A",
        "authorized_official_last_name": "DEPP",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "PAYER RELATIONS LIAISON",
        "authorized_official_telephone_number": "770-579-2626"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "40540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.