NPIMap

Organization Active NPI

Preventive Medicine Anti-Aging and Chelation Therapy Inc.

  • Point of Service
  • Sandy Springs, GA
National Provider Identifier
1114459096
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
PREVENTIVE MEDICINE ANTI-AGING AND CHELATION THERAPY INC.
Practice address
171 Mount Paran Rd NE
Sandy Springs, GA 30342-2211
Phone
(706) 891-1200
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Robert Burkich
Title
Director
Phone
(706) 891-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

171 Mount Paran Rd NE
Sandy Springs, GA 30342-2211

Mailing address

148 Cobb Pkwy
Ringgold, GA 30736-8566

National Provider Directory

National Provider Directory
Tax ID family
Preventive Medicine Anti-Aging and Chelation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1114459096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 COBB PKWY",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307368566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MOUNT PARAN RD NE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303422211",
            "telephone_number": "706-891-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ANTI-AGING AND CHELATION THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "BURKICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "706-891-1200"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.