NPIMap

Organization Active NPI

LTCC Enterprises LLC

  • Phlebotomy Technician
  • Stone Mountain, GA
National Provider Identifier
1508648536
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Legal business name
LTCC ENTERPRISES LLC
Practice address
933 N Hairston Rd Ste 4
Stone Mountain, GA 30083-2850
Phone
(404) 500-0087
NPI assigned
Oct 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Carmen CooperNPI 1639951668
Title
Owner
Phone
(404) 500-0087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X Primary

Addresses

Primary practice location

933 N Hairston Rd Ste 4
Stone Mountain, GA 30083-2850

Mailing address

933 N Hairston Rd Ste 4
Stone Mountain, GA 30083-2850
Phone (404) 500-0087

National Provider Directory

National Provider Directory

Locations

933 N Hairston Rd
Ste 4
Stone Mountain, GA 30083
Phone (404) 500-0087

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1508648536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N HAIRSTON RD STE 4",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832850",
            "telephone_number": "404-500-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N HAIRSTON RD STE 4",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832850",
            "telephone_number": "404-500-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTCC ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-500-0087"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.