Atlanta Family Medicine & Med Spa LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ATLANTA FAMILY MEDICINE & MED SPA LLC

Practice address

3915 Cascade Rd SW Ste 260
Atlanta, GA 30331-8522

Phone

(404) 277-1195

NPI assigned

Nov 22, 2024

Last updated

Nov 22, 2024By 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

Aminah Phelps, MDNPI 1467080218

Title

Doctor

Phone

(404) 277-1195

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aminah Danielle Phelps, MD

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1467080218
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1407672546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318522",
            "telephone_number": "404-277-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318522",
            "telephone_number": "404-277-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA FAMILY MEDICINE & MED SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "AMINAH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "404-277-1195",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.