Atlanta Men'S Clinic

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

Organization subpart

No

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

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clarissa Isabelle Giles, PA-C

  • Medical Physician Assistant
  • Marietta, GA
  • NPI 1164666962
  NPD (past)

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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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": []
}

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• Specialist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Specialist in Georgia

• 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.