Organization Active NPI

Lung & Sleep Specialist, LLC

  • Medical Specialty Clinic/Center
  • Dalton, GA
National Provider Identifier
1639598089
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
042678 Issued in GA
Legal business name
LUNG & SLEEP SPECIALIST, LLC
Practice address
1210 Broadrick Dr
Dalton, GA 30720-2676
Phone
(706) 277-4799
Fax
(706) 277-5054
NPI assigned
Apr 14, 2014
Last updated
Apr 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dr. Shaheen Noorani, MDNPI 1750372561
Title
Owner/Member
Phone
(706) 277-4799

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
Medical Specialty Clinic/Center 261QM2500X 042678 GA Primary

Addresses

Primary practice location

1210 Broadrick Dr
Dalton, GA 30720-2676

Mailing address

1210 Broadrick Dr
Dalton, GA 30720-2676
Phone (706) 277-4799

Other identifiers 2

IdentifierTypeStateIssuer
000744906CMedicaidGA
29BDCBJOtherGAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140523000290 GA Part B Supplier - Clinic/Group Practice 3375766140 Receives reassigned benefits from 1 practitioner
Practice locations: Dalton, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0965391Lung & Sleep Specialist, LLC1210 Broadrick Drive, Suite 1, Dalton, GA 30720Certificate of waiverMay 9, 2028

National Provider Directory

National Provider Directory

Locations

1210 Broadrick Dr
Dalton, GA 30720
Phone (706) 277-4799

1210 Broadrick Dr
Ste 1
Dalton, GA 30720
Phone (706) 277-4799

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": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1639598089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202676",
            "telephone_number": "706-277-4799",
            "fax_number": "706-277-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202676",
            "telephone_number": "706-277-4799",
            "fax_number": "706-277-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNG & SLEEP SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "NOORANI",
        "authorized_official_first_name": "SHAHEEN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "706-277-4799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "042678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000744906C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "29BDCBJ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.