Organization Active NPI

Gopaul Family LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Fayetteville, GA
National Provider Identifier
1366476251
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
GOPAUL FAMILY LLC
Practice address
100 Etowah Trace
Fayetteville, GA 30214
Phone
(770) 716-3433
Fax
(770) 716-1814
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Listra Gopaul
Title
Medical Director
Phone
(770) 716-3433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

100 Etowah Trace
Fayetteville, GA 30214

Mailing address

100 Etowah Trace
Fayetteville, GA 30214
Phone (770) 716-3433

Other names 1

  • Southern Sleep Studies Center Doing business as

National Provider Directory

National Provider Directory

Locations

100 Etowah Trce
Ste 200
Fayetteville, GA 30214
Phone (770) 716-3433

100 Etowah Trce
Fayetteville, GA 30214
Phone (770) 716-3433

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366476251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ETOWAH TRACE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-716-3433",
            "fax_number": "770-716-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ETOWAH TRACE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-716-3433",
            "fax_number": "770-716-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOPAUL FAMILY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOPAUL",
        "authorized_official_first_name": "LISTRA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-716-3433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Sleep Studies Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.