Provista Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROVISTA DIAGNOSTICS

Practice address

2001 Westside Pkwy Ste 240
Alpharetta, GA 30004-7408

Phone

(470) 758-2777

NPI assigned

Aug 4, 2020

Organization subpart

No

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

Authorized official

Name

Uriel Kusiatin

Title

Ceo

Phone

(470) 758-2777

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1346850468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 WESTSIDE PKWY STE 240",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047408",
            "telephone_number": "470-758-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WESTSIDE PKWY STE 240",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047408",
            "telephone_number": "470-758-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISTA DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "KUSIATIN",
        "authorized_official_first_name": "URIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-758-2777"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Dental Alliance of Alpharetta, LLC
• Progress ABA: Behavioral Consulting and Therapy Services, LLC
• Project Belle LLC
• Luke Prothro, M.S. CCC-SLP
• Provenance Rehabilitation
• John H Pruett Jr., LPC
• Psyched Inc
• Psychological Testing & Counseling Inc
• PT Solutions of Acworth LLC
• Public Partnerships Home Care LLC

• Clinical Medical Laboratory in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.