Organization Active NPI

Atlanta Lifestyle Medical Center

Doing business as Atlanta Lifestyle Medicine

  • Public Health & General Preventive Medicine Physician
  • Atlanta, GA
National Provider Identifier
1609194620
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
033801 Issued in GA
Legal business name
ATLANTA LIFESTYLE MEDICAL CENTER
Doing business as
Atlanta Lifestyle Medicine
Practice address
131 Ponce de Leon Ave NE
Suite 230
Atlanta, GA 30308-1962
Phone
(404) 769-3928
NPI assigned
May 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Authorized official

Name
Dr. Jennifer Rooke, MDNPI 1720114978
Title
Medical Director
Phone
(404) 769-3928

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
Public Health & General Preventive Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0901X 033801 GA Primary

Addresses

Primary practice location

131 Ponce de Leon Ave NE
Suite 230
Atlanta, GA 30308-1962

Mailing address

6090 Indian Wood Cir SE
Mableton, GA 30126-2969
Phone (404) 691-4549

Other names 1

  • Atlanta Lifestyle Medicine Doing business as

National Provider Directory

National Provider Directory

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": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1609194620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6090 INDIAN WOOD CIR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262969",
            "telephone_number": "404-691-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 PONCE DE LEON AVE NE",
            "address_2": "SUITE 230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081962",
            "telephone_number": "404-769-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA LIFESTYLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "ROOKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-769-3928",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "GA",
            "license": "033801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Lifestyle Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 14, 2010; 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.