Physical Wellness Group, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

027597 Issued in GA

Legal business name

PHYSICAL WELLNESS GROUP, LLC

Practice address

4153 Flat Shoals Pkwy
BLDG a
Decatur, GA 30034-4106

Phone

(888) 683-2304

NPI assigned

Apr 23, 2015

Last updated

Apr 23, 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

Harvey B Leslie, M.D.NPI 1992883201

Title

Ceo

Phone

(888) 683-2304

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harvey Bowen Leslie Sr., M.D.

  • Pain Medicine Physician
  • Decatur, GA
  • NPI 1992883201
  Authorized official Same address or phone

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1487041745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11877 DOUGLAS RD STE 102299",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300054325",
            "telephone_number": "888-683-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4153 FLAT SHOALS PKWY",
            "address_2": "BLDG A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300344106",
            "telephone_number": "888-683-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "LESLIE",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-683-2304",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "027597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Pier

• Specialist in Decatur, GA
• Providers in Decatur, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.