Integrative Medical Group and Medical Spa, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

INTEGRATIVE MEDICAL GROUP AND MEDICAL SPA, INC

Practice address

805 Lambert Dr NE Ste C
Atlanta, GA 30324-4189

Phone

(678) 561-3023

NPI assigned

Nov 19, 2019

Organization subpart

No

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

Authorized official

Name

Ava Cooper-Cadres

Title

Ceo

Phone

(678) 463-1719

Specialties & licenses 2

Addresses

Other names 1

• Integrative Medical Group and Medical Spa, Inc Other name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1417593047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 LAMBERT DR NE STE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244189",
            "telephone_number": "678-561-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 LAMBERT DR NE STE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244189",
            "telephone_number": "678-561-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICAL GROUP AND MEDICAL SPA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "COOPER-CADRES",
        "authorized_official_first_name": "AVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-463-1719"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ava@imgrps.com",
            "affiliation": "N",
            "endpointDescription": "IMGMSI",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "805 Lambert Dr NE Ste C",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303244189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Integrative Medical Group and Medical Spa, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.