NPIMap

Organization Active NPI

Tri Wellness Healthcare of Norcross, LLC

  • Physical Medicine & Rehabilitation Physician
  • Berkeley Lake, GA
National Provider Identifier
1245656099
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20140169 Issued in GA
Legal business name
TRI WELLNESS HEALTHCARE OF NORCROSS, LLC
Practice address
4870 Peachtree Industrial Blvd
Suite 500
Berkeley Lake, GA 30071-5732
Phone
(770) 798-9977
Fax
(770) 825-9118
NPI assigned
Mar 17, 2014
Last updated
Mar 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Authorized official

Name
Mr. Thomas Hourin, D.C.NPI 1255458576
Title
Business Office Director
Phone
(678) 214-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20140169 GA Primary

Addresses

Primary practice location

4870 Peachtree Industrial Blvd
Suite 500
Berkeley Lake, GA 30071-5732

Mailing address

4870 Peachtree Industrial Blvd
Suite 500
Berkeley Lake, GA 30071-5732
Phone (770) 798-9977

National Provider Directory

National Provider Directory

Locations

4870 Peachtree Industrial Blvd
Ste 500
Berkeley Lake, GA 30071
Phone (770) 427-7387

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": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1245656099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 500",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300715732",
            "telephone_number": "770-798-9977",
            "fax_number": "770-825-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 500",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300715732",
            "telephone_number": "770-798-9977",
            "fax_number": "770-825-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI WELLNESS HEALTHCARE OF NORCROSS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "HOURIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "678-214-0100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "20140169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Lake, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.