Organization Active NPI

Baptist Congregate of Atlanta Inc

  • General Practice Physician
  • Atlanta, GA
National Provider Identifier
1619097573
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
139425LGB Issued in GA
Legal business name
BAPTIST CONGREGATE OF ATLANTA INC
Practice address
165 Courtland St NE
Suite A301
Atlanta, GA 30303-1721
Phone
(404) 754-1914
Fax
(404) 724-0584
NPI assigned
Apr 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Javier E Fernandez
Title
Director
Phone
(404) 754-1914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 139425LGB GA Primary

Addresses

Primary practice location

165 Courtland St NE
Suite A301
Atlanta, GA 30303-1721

Mailing address

165 Courtland St NE
Suite A301
Atlanta, GA 30303-1721
Phone (404) 754-1914

National Provider Directory

National Provider Directory

Locations

165 Courtland St NE
Ste A301
Atlanta, GA 30303
Phone (404) 754-1914

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": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619097573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COURTLAND ST NE",
            "address_2": "SUITE A301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031721",
            "telephone_number": "404-754-1914",
            "fax_number": "404-724-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 COURTLAND ST NE",
            "address_2": "SUITE A301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031721",
            "telephone_number": "404-754-1914",
            "fax_number": "404-724-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST CONGREGATE OF ATLANTA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-754-1914",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "139425LGB",
            "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 Aug 22, 2020; 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.