NPIMap

Organization Active NPI

Chris 180, Inc.

  • Community/Behavioral Health Agency
  • Atlanta, GA
National Provider Identifier
1003377086
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHRIS 180, INC.
Doing business as
Adamsville Regional Health Center
Practice address
3700 Martin Luther King Dr SW
Atlanta, GA 30331-3674
Phone
(404) 486-9034
Fax
(404) 835-9350
NPI assigned
Mar 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mr. Dan James Bellor, BBA, PA, NP, AASEET
Title
Clinic Adminsitrator
Phone
(404) 486-9034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3700 Martin Luther King Dr SW
Atlanta, GA 30331-3674

Mailing address

1017 Fayetteville Rd SE
Atlanta, GA 30316-2932
Phone (404) 486-9034

Other identifiers 2

IdentifierTypeStateIssuer
300023628AMedicaidGA
640804505KMedicaidGA

Other names 1

  • Adamsville Regional Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chris 180 Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1553904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1003377086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162932",
            "telephone_number": "404-486-9034",
            "fax_number": "404-835-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 MARTIN LUTHER KING DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313674",
            "telephone_number": "404-486-9034",
            "fax_number": "404-835-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS 180, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-30",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "BELLOR",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CLINIC ADMINSITRATOR",
        "authorized_official_telephone_number": "404-486-9034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BBA, PA, NP, AASEET"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023628A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640804505K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adamsville Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 11, 2019; 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.