Active NPI
Done
- Psychiatry Physician
- Atlanta, GA
National Provider Identifier
1508648403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94465 | Other | GA | MD |
National Provider Directory
National Provider Directory- Tax ID family
- Done
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatry Physician
- Dublin, OH
- NPI 1043083694
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.