Neuro Matrix, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

NEURO MATRIX, LLC

Practice address

6250 Shiloh Rd Ste 110
Alpharetta, GA 30005-8400

Phone

(770) 781-0800

Fax

(770) 781-0814

NPI assigned

Jan 11, 2008

Last updated

Jan 11, 2008By 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

Katherine Ann Davis, CPA

Title

Chief Financial Officer

Phone

(770) 781-0800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1295911055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 SHILOH RD STE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058400",
            "telephone_number": "770-781-0800",
            "fax_number": "770-781-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 SHILOH RD STE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058400",
            "telephone_number": "770-781-0800",
            "fax_number": "770-781-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO MATRIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "770-781-0800",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Physiological Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.