Eleven 11 Medical Management, LLC

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

ELEVEN 11 MEDICAL MANAGEMENT, LLC

Practice address

438 Henry Ford II Ave
Hapeville, GA 30354-1622

Phone

(678) 235-2401

Fax

(678) 235-2403

NPI assigned

Mar 9, 2012

Last updated

Mar 9, 2012By 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

Ms. Cynthia Tate

Title

Administrator

Phone

(678) 235-2401

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1356616338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 HENRY FORD II AVE",
            "city": "HAPEVILLE",
            "state": "GA",
            "postal_code": "303541622",
            "telephone_number": "678-235-2401",
            "fax_number": "678-235-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 HENRY FORD II AVE",
            "city": "HAPEVILLE",
            "state": "GA",
            "postal_code": "303541622",
            "telephone_number": "678-235-2401",
            "fax_number": "678-235-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVEN 11 MEDICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-235-2401",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy Physician in Hapeville, GA
• Providers in Hapeville, GA by specialty
• Allergy Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.