Johns Creek Neurology, LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

JOHNS CREEK NEUROLOGY, LLC

Practice address

850 Dogwood Rd Ste B2002018
Lawrenceville, GA 30044-7218

Phone

(404) 900-9540

NPI assigned

Aug 14, 2019

Last updated

Aug 14, 2019By 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

Doreen Shinn

Title

Cfo

Phone

(404) 900-9540

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1336795400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 DOGWOOD RD STE B2002018",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 DOGWOOD RD STE B2002018",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447218",
            "telephone_number": "404-900-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS CREEK NEUROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-900-9540"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.