NPIMap

Organization Active NPI

Guadalupe LLC

  • Multi-Specialty Clinic/Center
  • Smyrna, GA
National Provider Identifier
1093413585
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GUADALUPE LLC
Doing business as
CLINICA LATINA
Practice address
696 Windy Hill Rd SE
Smyrna, GA 30080-1857
Phone
(404) 492-2093
NPI assigned
Feb 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Silvana Campos, ECT
Title
Manager
Phone
(404) 492-2093

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202C00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

696 Windy Hill Rd SE
Smyrna, GA 30080-1857

Mailing address

696 Windy Hill Rd SE
Smyrna, GA 30080-1857
Phone (404) 492-2093

Other identifiers 2

IdentifierTypeStateIssuer
1144226135OtherGAPRIVATE PRACTICE
1780076182OtherGAPRIVATE PRACTICE

Other names 1

  • CLINICA LATINA Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1093413585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 WINDY HILL RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801857",
            "telephone_number": "404-492-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 WINDY HILL RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801857",
            "telephone_number": "404-492-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "SILVANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-492-2093",
        "authorized_official_credential": "ECT"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Independent Medical Examiner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE",
            "identifier": "1144226135",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE",
            "identifier": "1780076182",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA LATINA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.