Organization Active NPI

Gut Rest Diagnostics LLC

  • Health Service Clinic/Center
  • Mineral Bluff, GA
National Provider Identifier
1629904305
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
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

Updated by the provider on Jun 22, 2026

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.