Northeast Georgia Diagnostic Associates and Clinic, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC

Doing business as

NGDC SLEEP MED LAB

Practice address

1240 Jesse Jewell Pkwy SE Ste 500
Gainesville, GA 30501-3861

Phone

(770) 536-9864

NPI assigned

Aug 30, 2018

Organization subpart

No

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

Authorized official

Name

Jorge J. Hernandez

Title

VP Admin./Cco

Phone

(404) 851-6378

Specialties & licenses 1

Addresses

Other names 1

• NGDC SLEEP MED LAB Doing business as

Locations

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1174005847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 600",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013863",
            "telephone_number": "770-536-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-536-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VP ADMIN./CCO",
        "authorized_official_telephone_number": "404-851-6378"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NGDC SLEEP MED LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

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