NPIMap

Organization Active NPI

Complete Laser Clinic of Atlanta

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
National Provider Identifier
1053768309
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
COMPLETE LASER CLINIC OF ATLANTA
Practice address
4751 Best Rd
Suite 400Q
Atlanta, GA 30337-5615
Phone
(678) 515-4607
Fax
(470) 355-8524
NPI assigned
May 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Mrs. Anishua M Roberts, CPC
Title
Manager
Phone
(678) 515-4607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

4751 Best Rd
Suite 400Q
Atlanta, GA 30337-5615

Mailing address

4751 Best Rd
Suite 400Q
Atlanta, GA 30337-5615
Phone (678) 515-4607

National Provider Directory

National Provider Directory

Locations

4751 Best Rd
Ste 400Q
Atlanta, GA 30337
Phone (678) 515-4607

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1053768309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 BEST RD",
            "address_2": "SUITE 400Q",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303375615",
            "telephone_number": "678-515-4607",
            "fax_number": "470-355-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 BEST RD",
            "address_2": "SUITE 400Q",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303375615",
            "telephone_number": "678-515-4607",
            "fax_number": "470-355-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE LASER CLINIC OF ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ANISHUA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-515-4607",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "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 17, 2016; 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.