NPIMap

Organization Active NPI

Progressive Healthcare of Gwinnett LLC

  • General Practice Physician
  • Lilburn, GA
National Provider Identifier
1174892392
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
37957 Issued in GA
Legal business name
PROGRESSIVE HEALTHCARE OF GWINNETT LLC
Practice address
670 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-1716
Phone
(770) 925-0088
Fax
(770) 925-3711
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Dr. Dennis Lew Rattiner, D.C.
Title
Owner
Phone
(404) 579-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 37957 GA Primary

Addresses

Primary practice location

670 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-1716

Mailing address

670 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-1716
Phone (770) 925-0088

National Provider Directory

National Provider Directory

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": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1174892392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471716",
            "telephone_number": "770-925-0088",
            "fax_number": "770-925-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471716",
            "telephone_number": "770-925-0088",
            "fax_number": "770-925-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HEALTHCARE OF GWINNETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "RATTINER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "LEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-579-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": "37957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.