Organization Active NPI

Atlanta Men's Clinic

  • Specialist
  • Suwanee, GA
National Provider Identifier
1124752886
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ATLANTA MEN'S CLINIC
Practice address
4411 Suwanee Dam Rd Ste 440
Suwanee, GA 30024-8706
Phone
(470) 589-7140
Fax
(844) 350-6954
NPI assigned
Jul 10, 2022
Last updated
Apr 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Diana Reeder, CCMA, CBCS
Title
Practice Administrator
Phone
(470) 589-7120

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X

Addresses

Primary practice location

4411 Suwanee Dam Rd Ste 440
Suwanee, GA 30024-8706

Mailing address

4411 Suwanee Dam Rd Ste 440
Suwanee, GA 30024-8706
Phone (470) 589-7140

Other identifiers 1

IdentifierTypeStateIssuer
1255728994OtherGANPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diana@atlantamensclinic.com Direct

National Provider Directory

National Provider Directory

Locations

4411 Suwanee Dam Rd
Ste 440
Suwanee, GA 30024
Phone (470) 589-7120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1124752886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD STE 440",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248706",
            "telephone_number": "470-589-7140",
            "fax_number": "844-350-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SUWANEE DAM RD STE 440",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248706",
            "telephone_number": "470-589-7140",
            "fax_number": "844-350-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA MEN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-10",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "REEDER",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "470-589-7120",
        "authorized_official_credential": "CCMA, CBCS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1255728994",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diana@atlantamensclinic.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4411 Suwanee Dam Rd Ste 440",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300248706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.