Organization Active NPI

CH Ga Central Georgia LLC

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1356741607
Registry record updated Aug 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CH GA CENTRAL GEORGIA LLC
Practice address
4055 Valley View LN
Suite 400
Dallas, TX 75244-5074
Phone
(972) 715-3800
Fax
(888) 722-4282
NPI assigned
Aug 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2014

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

Authorized official

Name
Melissa M Cooke
Title
Chief Financial Officer
Phone
(972) 715-3808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4055 Valley View LN
Suite 400
Dallas, TX 75244-5074

Mailing address

4055 Valley View LN
Suite 400
Dallas, TX 75244-5074
Phone (972) 715-3800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408752000000",
    "number": "1356741607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "972-715-3800",
            "fax_number": "888-722-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "972-715-3800",
            "fax_number": "888-722-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CH GA CENTRAL GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-23",
        "last_updated": "2014-08-23",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "972-715-3808"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; 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.