Le Reve Spinal Care Clinic Co.

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

License

33704 Issued in CA

Legal business name

LE REVE SPINAL CARE CLINIC CO.

Doing business as

Le Reve Spinal Care Clinic

Practice address

1827 Powers Ferry Rd SE
Building 7 , Suite 150
Atlanta, GA 30339-5621

Phone

(678) 401-3803

NPI assigned

Jan 22, 2016

Last updated

Sep 19, 2016By 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

Dr. Amir Ashkan Banishahi, D.CNPI 1235596156

Title

President/ Chiropractor

Phone

(310) 795-5265

Specialties & licenses 15

Addresses

Other names 1

• Le Reve Spinal Care Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amir A Banishahi, D.C

  • Independent Medical Examiner Chiropractor
  • Atlanta, GA
  • NPI 1235596156
  Authorized official Same address or phone

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1336506310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE",
            "address_2": "BUILDING 7 , SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621",
            "telephone_number": "678-401-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE",
            "address_2": "BUILDING 7 , SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621",
            "telephone_number": "678-401-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE REVE SPINAL CARE CLINIC CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "BANISHAHI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_middle_name": "ASHKAN",
        "authorized_official_title_or_position": "PRESIDENT/ CHIROPRACTOR",
        "authorized_official_telephone_number": "310-795-5265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "33704",
            "primary": false
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "GA",
            "license": "CHIR009638",
            "primary": false
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "33704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Le Reve Spinal Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Han Ngoc Le, PHARMD

• Independent Medical Examiner Chiropractor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Independent Medical Examiner Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.