Milestone Wellness Medical LLC

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

061005 Issued in GA

Legal business name

MILESTONE WELLNESS MEDICAL LLC

Practice address

8470 Holcomb Bridge Rd
140
Alpharetta, GA 30022-1854

Phone

(678) 461-9337

Fax

(678) 461-9338

NPI assigned

Sep 4, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Mojgan Shahmar

Title

Owner

Phone

(404) 862-0372

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1275901449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8470 HOLCOMB BRIDGE RD",
            "address_2": "140",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221854",
            "telephone_number": "678-461-9337",
            "fax_number": "678-461-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8470 HOLCOMB BRIDGE RD",
            "address_2": "140",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221854",
            "telephone_number": "678-461-9337",
            "fax_number": "678-461-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE WELLNESS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "SHAHMAR",
        "authorized_official_first_name": "MOJGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-862-0372",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "GA",
            "license": "032720",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "GA",
            "license": "061005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE PROVIDER",
            "identifier": "1144255399",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE PROVIDER",
            "identifier": "1447494885",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Metabolic Nutrition Registered Dietitian in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Metabolic Nutrition Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.