NPIMap

Organization Active NPI

Premier Image Cosmetic & Laser Surgery

  • Specialist
  • Atlanta, GA
National Provider Identifier
1457563447
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PREMIER IMAGE COSMETIC & LASER SURGERY
Practice address
4553 N Shallowford Road
20B
Atlanta, GA 30338
Phone
(770) 457-6303
Fax
(770) 457-2823
NPI assigned
May 4, 2007
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
Ms. Jeanette Hames
Title
Practice Administrator
Phone
(770) 457-6303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

4553 N Shallowford Road
20B
Atlanta, GA 30338

Mailing address

4553 N Shallowford Road
20B
Atlanta, GA 30338
Phone (770) 457-6303

National Provider Directory

National Provider Directory

Locations

4553 N Shallowford Rd
Ste 20B
Atlanta, GA 30338
Phone (770) 457-6303

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457563447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 N SHALLOWFORD ROAD",
            "address_2": "20B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "770-457-6303",
            "fax_number": "770-457-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 N SHALLOWFORD ROAD",
            "address_2": "20B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "770-457-6303",
            "fax_number": "770-457-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER IMAGE COSMETIC & LASER SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMES",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-457-6303",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, 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.