NPIMap

Organization Active NPI

Ant-Aging Queen

  • Nutritionist
  • Atlanta, GA
National Provider Identifier
1528501723
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
LD004146 Issued in GA
Legal business name
ANT-AGING QUEEN
Practice address
1801 Atlanta Medical Clinic
Suite 250
Atlanta, GA 30309
Phone
(404) 353-3482
NPI assigned
Nov 21, 2016
Last updated
Nov 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Jennifer Hnat, LD
Title
Owner
Phone
(404) 353-3482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X LD004146 GA Primary

Addresses

Primary practice location

1801 Atlanta Medical Clinic
Suite 250
Atlanta, GA 30309

Mailing address

1801 Atlanta Medical Clinic
Suite 250
Atlanta, GA 30309

Other identifiers 1

IdentifierTypeStateIssuer
1023446069OtherNPI

National Provider Directory

National Provider Directory
Tax ID family
Ant-Aging Queen2 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": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1528501723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ATLANTA MEDICAL CLINIC",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ATLANTA MEDICAL CLINIC",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-353-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANT-AGING QUEEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "HNAT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-353-3482",
        "authorized_official_credential": "LD"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "GA",
            "license": "LD004146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1023446069",
            "state": null
        }
    ],
    "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 21, 2016; 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.