Pact Atlanta, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036495 Issued in GA

Legal business name

PACT ATLANTA, LLC

Practice address

465 Winn Way Ste 221
Decatur, GA 30030-1723

Phone

(404) 292-3810

Fax

(404) 292-3848

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Todd M Antin, M.D.

Title

Ceo

Phone

(404) 292-3810

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114092202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WINN WAY STE 221",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301723",
            "telephone_number": "404-292-3810",
            "fax_number": "404-292-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WINN WAY STE 221",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301723",
            "telephone_number": "404-292-3810",
            "fax_number": "404-292-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACT ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANTIN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-292-3810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "036495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Nnenna Ozim, NURSE PRACTITIONER
• Leslye Howell Pace, M.D.
• Hailey Christine Wetta Pachciarz, PA-C
• Guadalupe Rosario Pacheco, DC
• Pact Atlanta Pharmacy LLC
• Keerthi Reddy Padooru, MD
• Rekha Pagadala, AA
• Patricia Zartman Page, MS, CGC
• Pain Care Store
• Pain Control & Rehabilitation Institute of Georgia, Inc.

• All providers in Decatur, GA
• Medical Specialty Clinic/Center in Georgia

• 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.