NPIMap

Organization Active NPI

Kuraoka Clinic

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1144543877
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
056473 Issued in GA
Legal business name
KURAOKA CLINIC
Practice address
100 Galleria Pkwy SE
Suite 660
Atlanta, GA 30339-3179
Phone
(770) 980-0000
Fax
(770) 217-4164
NPI assigned
Mar 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Authorized official

Name
Dr. Maki Kuraoka Rheaume, M.D.NPI 1174556542
Title
President
Phone
(770) 980-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 056473 GA Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X 054657 GA

Addresses

Primary practice location

100 Galleria Pkwy SE
Suite 660
Atlanta, GA 30339-3179

Mailing address

100 Galleria Paryway, S.E.
Suite 660
Atlanta, GA 30339
Phone (770) 980-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210119002206 GA Part B Supplier - Mass Immunization (Roster Biller Only) 3173936820 Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

1640 Powers Ferry Rd SE
Bldg 30
Marietta, GA 30067
Phone (770) 956-9212

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1144543877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GALLERIA PARYWAY, S.E.",
            "address_2": "SUITE 660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "770-980-0000",
            "fax_number": "770-217-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GALLERIA PKWY SE",
            "address_2": "SUITE 660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393179",
            "telephone_number": "770-980-0000",
            "fax_number": "770-217-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KURAOKA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "RHEAUME",
        "authorized_official_first_name": "MAKI",
        "authorized_official_middle_name": "KURAOKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-980-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "056473",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "054657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.