Organization Active NPI

Concierge Diagnostic Services LLC

  • Phlebotomy Technician
  • Columbus, GA
National Provider Identifier
1164210266
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Legal business name
CONCIERGE DIAGNOSTIC SERVICES LLC
Practice address
1220 2ND Ave Ste 6
Columbus, GA 31901-1114
Phone
(470) 241-6604
Fax
(706) 940-4415
NPI assigned
Apr 28, 2025
Last updated
May 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Dr. Corinthians Dequindrae Washington, Ed.D., DO, CDCA, ED.D.
Title
Administrator
Phone
(470) 241-6604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chemical Pathology Physician 207ZP0104X
Phlebotomy Technician 246RP1900X Primary

Addresses

Primary practice location

1220 2ND Ave Ste 6
Columbus, GA 31901-1114

Mailing address

1220 2ND Ave Ste 106
Columbus, GA 31901-1111
Phone (470) 241-6604

National Provider Directory

National Provider Directory

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": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1164210266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE STE 106",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011111",
            "telephone_number": "470-241-6604",
            "fax_number": "706-940-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE STE 6",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011114",
            "telephone_number": "470-241-6604",
            "fax_number": "706-940-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON, ED.D.",
        "authorized_official_first_name": "CORINTHIANS",
        "authorized_official_middle_name": "DEQUINDRAE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "470-241-6604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, CDCA, ED.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0104X",
            "taxonomy_group": "",
            "desc": "Pathology, Chemical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.