Georgia State Diagnostics LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GEORGIA STATE DIAGNOSTICS LLC

Practice address

3379 Peachtree Rd NE
Suite 555
Atlanta, GA 30326-1031

Phone

(407) 474-9253

NPI assigned

Mar 9, 2015

Last updated

Mar 9, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

NATIONAL DIAGNOSTIC SOLUTIONS LLCAs reported in NPPES

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

Authorized official

Name

Keith Fernandez

Title

Manager

Phone

(407) 474-9253

Specialties & licenses 1

Addresses

Part of

National Diagnostic Solutions LLC

Locations

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1609269018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 PEACHTREE RD NE",
            "address_2": "SUITE 555",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3379 PEACHTREE RD NE",
            "address_2": "SUITE 555",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261031",
            "telephone_number": "407-474-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA STATE DIAGNOSTICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL DIAGNOSTIC SOLUTIONS LLC",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-474-9253"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.