Idea Body Institute Atlanta ASC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

IDEA BODY INSTITUTE ATLANTA ASC

Doing business as

Idea Body Institute Atlanta ASC

Practice address

371 E Paces Ferry Rd NE Ste 450
Atlanta, GA 30305-3292

Phone

(678) 466-6760

NPI assigned

Jan 27, 2020

Last updated

Feb 17, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

GEORGIA SURGICAREAs reported in NPPES

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

Authorized official

Name

Natasha Lindsay

Title

Credentialing Coordinator

Phone

(678) 466-6760

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Idea Body Institute Atlanta ASC Doing business as

Part of

Georgia Surgicare

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Georgia Surgicare

  • Multi-Specialty Clinic/Center
  • Loganville, GA
  • NPI 1508150509
  NPPES parent name

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1285265546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053292",
            "telephone_number": "678-466-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053292",
            "telephone_number": "678-466-6760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 Athens Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300522207",
            "country_code": "US",
            "telephone_number": "678-466-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IDEA BODY INSTITUTE ATLANTA ASC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA SURGICARE",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "LINDSAY",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "678-466-6760"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992981302",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558539155",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idea Body Institute Atlanta ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.