Intensive Neuromonitoring LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

69752 Issued in GA

Legal business name

INTENSIVE NEUROMONITORING LLC

Practice address

2152 Spring Creek Rd
Decatur, GA 30033-2608

Phone

(404) 831-8168

NPI assigned

Oct 19, 2015

Organization subpart

No

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

Authorized official

Name

Eric Robert Anderson, MD, PHD

Title

Owner - Managing Officer

Phone

(404) 831-8168

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1457722209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 SPRING CREEK RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332608",
            "telephone_number": "404-831-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 SPRING CREEK RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332608",
            "telephone_number": "404-831-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE NEUROMONITORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER - MANAGING OFFICER",
        "authorized_official_telephone_number": "404-831-8168",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "69752",
            "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 Jun 29, 2016; 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.