Organization Active NPI

Done

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1508648403
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DONE
Practice address
1201 W Peachtree St NW Ste 2300
Atlanta, GA 30309-3453
Phone
(415) 735-5804
NPI assigned
Oct 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Credentialing Department
Title
Office Manager/Business Staff Conta
Phone
(415) 671-2165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1201 W Peachtree St NW Ste 2300
Atlanta, GA 30309-3453

Mailing address

1201 W Peachtree St NW Ste 2300
Atlanta, GA 30309-3453
Phone (415) 735-5804

Other identifiers 1

IdentifierTypeStateIssuer
94465OtherGAMD

National Provider Directory

National Provider Directory
Tax ID family
Done2 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.

NPI Registry JSON

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1508648403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W PEACHTREE ST NW STE 2300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093453",
            "telephone_number": "415-735-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W PEACHTREE ST NW STE 2300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093453",
            "telephone_number": "415-735-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-11-08",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "DEPARTMENT",
        "authorized_official_first_name": "CREDENTIALING",
        "authorized_official_title_or_position": "OFFICE MANAGER/BUSINESS STAFF CONTA",
        "authorized_official_telephone_number": "415-671-2165"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "94465",
            "state": "GA"
        }
    ],
    "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 Nov 8, 2023; 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.