Atlanta Innovative Medicine, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ATLANTA INNOVATIVE MEDICINE, LLC

Practice address

8460 Holcomb Bridge Rd Ste 200
Alpharetta, GA 30022-6868

Phone

(770) 416-9995

NPI assigned

Oct 30, 2019

Last updated

Feb 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kruti Patel

Title

Office Manager

Phone

(770) 416-9995

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 2

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.

• Farhan Javed Malik, M.D.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1699941286
  Medicare reassignment Care Compare group NPD
• Steven C Mercante, DC

  • Chiropractor
  • Norcross, GA
  • NPI 1487779625
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1093359382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8460 HOLCOMB BRIDGE RD STE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8460 HOLCOMB BRIDGE RD STE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226868",
            "telephone_number": "770-416-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA INNOVATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KRUTI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-416-9995"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Atlanta General Surgery Associates,PC
• Atlanta Hair Restoration
• Atlanta Medical Sourcing and Services LLC
• Atlanta Outpatient Ancillary Services, LLC
• Atlanta Senior Care Services, LLC (Inspired Living at Alpharetta)
• Atlanta Skin Cancer Specialists, P.C.
• Atlanta Speech Therapy, LLC

• Physical Medicine & Rehabilitation Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.