Midtown Medical Center, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

027368 Issued in GA

Legal business name

MIDTOWN MEDICAL CENTER, LLC

Practice address

197 14TH St NW Ste 100
Atlanta, GA 30318-7827

Phone

(404) 343-1649

NPI assigned

Jun 29, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Khamis Ibrahim

Title

Director

Phone

(404) 343-1649

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Regional Oncology, LLC

  • Hematology & Oncology Physician
  • Columbus, GA
  • NPI 1982778239
  NPPES parent name

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1134416100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 14TH ST NW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303187827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 14TH ST NW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303187827",
            "telephone_number": "404-343-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "KHAMIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-343-1649",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "027368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Midtown Optical Inc
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• Specialist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.