Integrated Health and Wellness, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRATED HEALTH AND WELLNESS, LLC

Practice address

4150 Snapfinger Woods Dr Ste 200
Decatur, GA 30035-3417

Phone

(404) 289-4815

Fax

(678) 705-8429

NPI assigned

Mar 16, 2018

Last updated

Mar 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Gibson, MDNPI 1750589891

Title

Physician

Phone

(404) 289-4815

Specialties & licenses 1

Addresses

Locations

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.

• Michael Anthony Gibson Sr., M.D.

  • Internal Medicine Physician
  • Smyrna, GA
  • NPI 1750589891
  NPD Authorized official

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1235632282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 S COBB DR SE STE H-302",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806990",
            "telephone_number": "404-289-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 SNAPFINGER WOODS DR STE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300353417",
            "telephone_number": "404-289-4815",
            "fax_number": "678-705-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-289-4815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.