Cota Medical Management

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2015007976 Issued in GA

Legal business name

COTA MEDICAL MANAGEMENT

Doing business as

Clinica de la Mama

Practice address

3750 Venture Dr
Suite 140
Duluth, GA 30096-1808

Phone

(678) 584-5865

NPI assigned

Nov 9, 2015

Last updated

Nov 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Felipe Cota

Title

Cfo

Phone

(678) 584-5865

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CLINICA DE LA MAMA Doing business as

Tax ID family

Clinica de la Mama2 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.

• Cota Medical Management

  dba Clinica de la Mama

  • Maternal & Fetal Medicine Physician
  • Norcross, GA
  • NPI 1467745356
  NPD tax ID

Locations

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1487027736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 VENTURE DR",
            "address_2": "SUITE 140",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961808",
            "telephone_number": "678-584-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 VENTURE DR",
            "address_2": "SUITE 140",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961808",
            "telephone_number": "678-584-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTA MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "COTA",
        "authorized_official_first_name": "FELIPE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-584-5865",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "2015007976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10937577239",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10533405993",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA DE LA MAMA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Arthur Cornett, M.A. NCC LPC CPCS
• Costco Wholesale Corporation (Costco Optical #187)
• Costco Wholesale Corporation (Costco Hearing Aid #187)
• Costco Wholesale Corporation (Costco Pharmacy # 187)
• Kelly Anne Costello
• Carmen Idalys Cotto, O.D.
• Mackenzie W Couch, MS,BCBA
• Bakaramoko Coulibaly, RPH
• Counseling Center at Duluth LLC
• Elizabeth Anne Coursey, CPNP-PC

• Clinical Medical Laboratory in Duluth, GA
• Providers in Duluth, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.