Organization Active NPI

Clinica de la Salud Smyrna, Inc

Doing business as Clinica de la salud Smyrna

  • Family Medicine Physician
  • Marietta, GA
National Provider Identifier
1053885327
Registry record updated Jan 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA DE LA SALUD SMYRNA, INC
Doing business as
Clinica de la salud Smyrna
Practice address
1815 S Cobb Dr SE Ste 101
Marietta, GA 30060-4958
Phone
(678) 888-0173
Fax
(678) 888-0177
NPI assigned
Jan 19, 2019
Last updated
Jan 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2019

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

Authorized official

Name
Dr. Henry Velez Jr., MD
Title
Medical Director
Phone
(404) 406-7861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1815 S Cobb Dr SE Ste 101
Marietta, GA 30060-4958

Mailing address

1815 S Cobb Dr SE Ste 101
Marietta, GA 30060-4958
Phone (678) 888-0173

Other identifiers 3

IdentifierTypeStateIssuer
1710082458OtherGANO INSURANCE
1437461050OtherGANO INSURANCE
1932467768OtherGANO INSURANCE

Other names 1

  • Clinica de la salud Smyrna Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2201605Clinica de la Salud Smyrna1815 South Cobb Drive Suite 101, Marietta, GA 30060Certificate of waiverNov 22, 2026

National Provider Directory

National Provider Directory

Locations

1815 S Cobb Dr SE
Ste 101
Marietta, GA 30060
Phone (678) 888-0173

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1547856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547856000000",
    "number": "1053885327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 S COBB DR SE STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300604958",
            "telephone_number": "678-888-0173",
            "fax_number": "678-888-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 S COBB DR SE STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300604958",
            "telephone_number": "678-888-0173",
            "fax_number": "678-888-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE LA SALUD SMYRNA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-19",
        "last_updated": "2019-01-19",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-406-7861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURANCE",
            "identifier": "1710082458",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURANCE",
            "identifier": "1437461050",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURANCE",
            "identifier": "1932467768",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica de la salud Smyrna",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.