Organization Active NPI

Vibrant Family Medicine, P.C.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1598319287
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VIBRANT FAMILY MEDICINE, P.C.
Practice address
6667 Vernon Woods Dr Ste A19
Atlanta, GA 30328-3215
Phone
(404) 396-1640
NPI assigned
Jul 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Dr. Bradford Gould, M.D.
Title
Doctor/President
Phone
(404) 396-1640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6667 Vernon Woods Dr Ste A19
Atlanta, GA 30328-3215

Mailing address

4903 Heatherdale LN
Atlanta, GA 30360-1615
Phone (404) 396-1640

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2176305Vibrant Family Medicine, PC6667 Vernon Woods Drive, Suite a-19, Atlanta, GA 30328Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory

Locations

6667 Vernon Woods Dr
Apt 19
Sandy Springs, GA 30328

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1598319287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 HEATHERDALE LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303601615",
            "telephone_number": "404-396-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6667 VERNON WOODS DR STE A19",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283215",
            "telephone_number": "404-396-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "404-396-1640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.