Active NPI
Medimprove Clinical LLC
- Pulmonary Disease Physician
- Atlanta, GA
National Provider Identifier
1548072580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- Legal business name
- MEDIMPROVE CLINICAL LLC
- Practice address
- 371 E Paces Ferry Rd NE
Atlanta, GA 30305-2372 - Phone
- (646) 285-3174
- NPI assigned
- Jan 27, 2025
- 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
- Jan De Backer
- Title
- Chief Administrative Officer
- Phone
- (646) 258-3174
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | Primary |
Addresses
Primary practice location
371 E Paces Ferry Rd NE
Atlanta, GA 30305-2372
Mailing address
371 E Paces Ferry Rd NE
Atlanta, GA 30305-2372
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
371 E Paces Ferry Rd NE
Atlanta, GA 30305
Phone (404) 400-3120
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Atlanta, GA
- NPI 1396825691
-
- Physician Assistant
- Atlanta, GA
- NPI 1881946440
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1083052351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737936000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737936000000",
"number": "1548072580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 E PACES FERRY RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303052372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "371 E PACES FERRY RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303052372",
"telephone_number": "646-285-3174"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDIMPROVE CLINICAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-27",
"last_updated": "2025-01-27",
"certification_date": "2025-01-23",
"status": "A",
"authorized_official_last_name": "DE BACKER",
"authorized_official_first_name": "JAN",
"authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "646-258-3174"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jan 27, 2025; 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.