Wisemen Clinical Research Group, LLC

Primary specialty

Research Clinic/CenterTaxonomy code 261QR1100X

Legal business name

WISEMEN CLINICAL RESEARCH GROUP, LLC

Practice address

3300 Memorial Dr
Suite D-1
Decatur, GA 30032-2700

Phone

(404) 474-1224

Fax

(404) 891-0391

NPI assigned

May 14, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Anthonette Louise Waajid

Title

Business Manager

Phone

(404) 474-1224

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1104204718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MEMORIAL DR",
            "address_2": "SUITE D-1",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322700",
            "telephone_number": "404-474-1224",
            "fax_number": "404-891-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MEMORIAL DR",
            "address_2": "SUITE D-1",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322700",
            "telephone_number": "404-474-1224",
            "fax_number": "404-891-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISEMEN CLINICAL RESEARCH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "WAAJID",
        "authorized_official_first_name": "ANTHONETTE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "404-474-1224",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Robert Wing, MD
• Amy Elizabeth Wingard, PSYD
• James Richard Winston Jr., M.D.
• Rebecca L Winston, MSW
• Marvin Robert Winter, D.D.S.
• Wiser Ground LLC
• Dianne Wisham, LAPC
• Wishing Well Counseling, LLC
• Wisteria Counseling
• Melvin Trevor Witcher, RPH

• Research Clinic/Center in Decatur, GA
• Providers in Decatur, GA by specialty
• Research Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.