Due West Integrated Health Center Physical Medicine, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

28809 Issued in GA

Legal business name

DUE WEST INTEGRATED HEALTH CENTER PHYSICAL MEDICINE, LLC

Practice address

1600 Kennesaw Due West Rd NW
Suite 501
Kennesaw, GA 30152-4301

Phone

(770) 429-5555

NPI assigned

Oct 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. John P Lanier, M.D.

Title

Medical Director

Phone

(770) 429-5555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1275819088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 KENNESAW DUE WEST RD NW STE 501",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524304",
            "telephone_number": "770-429-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 KENNESAW DUE WEST RD NW",
            "address_2": "SUITE 501",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524301",
            "telephone_number": "770-429-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUE WEST INTEGRATED HEALTH CENTER PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-429-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "28809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.