NPIMap

Organization Active NPI

Theramed Health, LLC

  • Family Medicine Physician
  • Kennesaw, GA
National Provider Identifier
1487056586
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THERAMED HEALTH, LLC
Practice address
3440 Blue Springs Rd NW Ste 503
Kennesaw, GA 30144-1038
Phone
(404) 857-9575
Fax
(888) 857-4685
NPI assigned
Sep 19, 2014
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Nicole Reed
Title
Chief Executive Officer
Phone
(404) 857-9575

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X

Addresses

Primary practice location

3440 Blue Springs Rd NW Ste 503
Kennesaw, GA 30144-1038

Mailing address

3440 Blue Springs Rd NW Ste 503
Kennesaw, GA 30144-1038
Phone (404) 857-9575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150121001157 GA Part B Supplier - Clinic/Group Practice 0345564472 Receives reassigned benefits from 19 practitioners
Practice locations: Kennesaw, GA

National Provider Directory

National Provider Directory

Locations

3250 Quick Water Lndg NW
Kennesaw, GA 30144
Phone (404) 857-9575

3440 Blue Springs Rd NW
Ste 503
Kennesaw, GA 30144
Phone (404) 513-5053

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1487056586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 BLUE SPRINGS RD NW STE 503",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441038",
            "telephone_number": "404-857-9575",
            "fax_number": "888-857-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 BLUE SPRINGS RD NW STE 503",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441038",
            "telephone_number": "404-857-9575",
            "fax_number": "888-857-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAMED HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "404-857-9575"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.