Emergent Testing Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EMERGENT TESTING LAB LLC

Practice address

13 Corporate Blvd NE Ste 250
Brookhaven, GA 30329-1901

Phone

(678) 941-4278

NPI assigned

Sep 10, 2020

Last updated

Oct 4, 2023By 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. Jonathan Goss, MDNPI 1992110555

Title

Owner

Phone

(713) 819-6417

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Enrollment records 2

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.

• Jonathan Goss, M.D.

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1992110555
  NPD (past) Authorized official

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1255946869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 CORPORATE BLVD NE STE 250",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291901",
            "telephone_number": "470-467-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 CORPORATE BLVD NE STE 250",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291901",
            "telephone_number": "678-941-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENT TESTING LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "GOSS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-819-6417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.