Iwc East LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IWC EAST LLC

Practice address

40 Technology Parkway
#300
Norcross, GA 30092

Phone

(404) 423-6840

NPI assigned

Feb 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Shue Kothari

Title

Owner

Phone

(404) 423-6840

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1598205239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TECHNOLOGY PARKWAY",
            "address_2": "#300",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TECHNOLOGY PARKWAY",
            "address_2": "#300",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30092",
            "telephone_number": "404-423-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IWC EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "KOTHARI",
        "authorized_official_first_name": "SHUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-423-6840",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.