NPIMap

Organization Active NPI

Candid Medical Center, LLC

  • Pain Medicine Physician
  • Riverdale, GA
National Provider Identifier
1437494523
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
CANDID MEDICAL CENTER, LLC
Practice address
6525 Professional PL
Suite C
Riverdale, GA 30274-2519
Phone
(770) 994-1250
NPI assigned
Nov 30, 2012
Last updated
Nov 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Authorized official

Name
Bodo Pyko, M.D.
Title
Medical Director
Phone
(770) 994-1250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

6525 Professional PL
Suite C
Riverdale, GA 30274-2519

Mailing address

500 W Main St
Suite 108
Babylon, NY 11702-3027
Phone (631) 930-5215

National Provider Directory

National Provider Directory
Tax ID family
Candid Medical Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 W Main St
Ste 108
Babylon, NY 11702

NPI Registry JSON

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1437494523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE 108",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023027",
            "telephone_number": "631-930-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 PROFESSIONAL PL",
            "address_2": "SUITE C",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742519",
            "telephone_number": "770-994-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDID MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-30",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "PYKO",
        "authorized_official_first_name": "BODO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-994-1250",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.