Active NPI
Gut Rest Diagnostics LLC
- Health Service Clinic/Center
- Mineral Bluff, GA
National Provider Identifier
1629904305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- GUT REST DIAGNOSTICS LLC
- Practice address
- 110 Sweetgum LN
Mineral Bluff, GA 30559-2588 - Phone
- (323) 772-6313
- NPI assigned
- Jun 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael David Erdman, MBBS
- Title
- Owner
- Phone
- (310) 866-7464
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Primary |
Addresses
Primary practice location
110 Sweetgum LN
Mineral Bluff, GA 30559-2588
Mailing address
110 Sweetgum LN
Mineral Bluff, GA 30559-2588
Phone (323) 772-6313
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782086400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782086400000",
"number": "1629904305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SWEETGUM LN",
"city": "MINERAL BLUFF",
"state": "GA",
"postal_code": "305592588",
"telephone_number": "323-772-6313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SWEETGUM LN",
"city": "MINERAL BLUFF",
"state": "GA",
"postal_code": "305592588",
"telephone_number": "323-772-6313"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GUT REST DIAGNOSTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-06-22",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A",
"authorized_official_last_name": "ERDMAN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "310-866-7464",
"authorized_official_credential": "MBBS"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mineral Bluff, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.