Organization Active NPI

GYN Atlanta, PC

  • Gynecologic Oncology Physician
  • Atlanta, GA
National Provider Identifier
1033715974
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
GYN ATLANTA, PC
Practice address
5430 Glenridge Dr
Atlanta, GA 30342-1342
Phone
(404) 250-3600
Fax
(404) 381-2176
NPI assigned
Dec 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Dr. Joseph Francis Boveri, MDNPI 1154397677
Title
President
Phone
(404) 250-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0201X Primary

Addresses

Primary practice location

5430 Glenridge Dr
Atlanta, GA 30342-1342

Mailing address

1067 Stovall Blvd NE
Atlanta, GA 30319-1220
Phone (404) 312-1047

Other identifiers 1

IdentifierTypeStateIssuer
000622949EMedicaidGA

National Provider Directory

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": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1033715974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 STOVALL BLVD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303191220",
            "telephone_number": "404-312-1047",
            "fax_number": "404-481-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 GLENRIDGE DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421342",
            "telephone_number": "404-250-3600",
            "fax_number": "404-381-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYN ATLANTA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "BOVERI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-250-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000622949E",
            "state": "GA"
        }
    ],
    "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 Dec 7, 2020; 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.