Organization Active NPI

Just Breast, LLC

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1457789570
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
59206 Issued in GA
Legal business name
JUST BREAST, LLC
Practice address
1841 Hedge Rose Dr NE
Atlanta, GA 30324-2784
Phone
(708) 320-1465
Fax
(404) 343-0888
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Dr. April Latrice Speed, MD
Title
Ceo
Phone
(708) 320-1465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 59206 GA Primary

Addresses

Primary practice location

1841 Hedge Rose Dr NE
Atlanta, GA 30324-2784

Mailing address

1800 Howell Mill Rd NW
Atlanta, GA 30318-2538
Phone (708) 320-1465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131209001473 GA Part B Supplier - Clinic/Group Practice 3375770837 Receives reassigned benefits from 1 practitioner
Practice locations: Conyers, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1457789570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "708-320-1465",
            "fax_number": "404-343-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 HEDGE ROSE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303242784",
            "telephone_number": "708-320-1465",
            "fax_number": "404-343-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST BREAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "SPEED",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "LATRICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-320-1465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "59206",
            "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 Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.