NPIMap

Organization Active NPI

Hispanic Medical Management

  • Clinical Medical Laboratory
  • Norcross, GA
National Provider Identifier
1104959485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
HISPANIC MEDICAL MANAGEMENT
Practice address
5127 Jimmy Carter Blvd
Norcross, GA 30093-1619
Phone
(770) 613-0070
Fax
(770) 613-0909
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Tracey Cota
Title
Coo
Phone
(770) 613-0070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

5127 Jimmy Carter Blvd
Norcross, GA 30093-1619

Mailing address

5127 Jimmy Carter Blvd
Norcross, GA 30093-1619
Phone (770) 613-0070

Other names 1

  • CLINICA DE LA MAMA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clinica de la Mama4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104959485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5127 JIMMY CARTER BLVD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931619",
            "telephone_number": "770-613-0070",
            "fax_number": "770-613-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5127 JIMMY CARTER BLVD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931619",
            "telephone_number": "770-613-0070",
            "fax_number": "770-613-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISPANIC MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COTA",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-613-0070",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA DE LA MAMA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.