Concierge Medical MGMT Group

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

CONCIERGE MEDICAL MGMT GROUP

Practice address

760 Old Roswell Rd Ste 117
Roswell, GA 30076

Phone

(800) 704-8875

Fax

(888) 816-7047

NPI assigned

Feb 2, 2016

Organization subpart

No

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

Authorized official

Name

Nancy Bonner

Title

President

Phone

(678) 500-9568

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526083200000",
    "number": "1447618707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 OLD ROSWELL RD STE 117",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300768685",
            "telephone_number": "800-704-8875",
            "fax_number": "888-840-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 OLD ROSWELL RD STE 117",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "800-704-8875",
            "fax_number": "888-816-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE MEDICAL MGMT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2018-05-12",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-500-9568"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2018; 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.