Preventclinic, Inc.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PREVENTCLINIC, INC.

Practice address

6000 Lake Forrest Dr Ste 540
Sandy Springs, GA 30328

Phone

(470) 735-5045

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

David E. MontgomeryNPI 1407027014

Title

Owner/ Physician

Phone

(470) 735-5045

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David E. Montgomery, MD

  • Cardiovascular Disease Physician
  • Sandy Springs, GA
  • NPI 1407027014
  Medicare reassignment Care Compare group NPD Authorized official
• Celeste Miller, MD

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1477870020
  Medicare reassignment Care Compare group NPD
• Lauren Whitney Powell, MD

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1275947483
  Medicare reassignment Care Compare group NPD
• Ektaa Patel

  • Family Nurse Practitioner
  • Sandy Springs, GA
  • NPI 1033694765
  Medicare reassignment NPD

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1306346853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 LAKE FORREST DR STE 540",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285902",
            "telephone_number": "470-735-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 LAKE FORREST DR STE 540",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "30328",
            "telephone_number": "470-735-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTCLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER/ PHYSICIAN",
        "authorized_official_telephone_number": "470-735-5045"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Posner
• Bethany Powell
• Rondrea Powell, NURSE PRACTITIONER
• Preeminent Medical Services, LLC
• Premier Health Care
• Preventive Medicine & Anti-Aging Institute LLC
• Preventive Medicine Anti-Aging and Chelation Therapy Inc.
• Preventive Medicine Anti-Aging and Chelation, Inc
• Primrose Pharmacy LLC
• Tinika Prince

• Cardiovascular Disease Physician in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.