University Neuro, LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

UNIVERSITY NEURO, LLC

Practice address

925B Peachtree St NE Ste 710
Atlanta, GA 30309-3918

Phone

(609) 380-3305

NPI assigned

Jun 5, 2017

Last updated

Oct 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doreen Shinn

Title

VP & Cfo

Phone

(609) 380-3305

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1639608516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 880256 PO BOX 29650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389650",
            "telephone_number": "609-380-3305",
            "fax_number": "609-521-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925B PEACHTREE ST NE STE 710",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093918",
            "telephone_number": "609-380-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Central Expy Unit 1955",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "75070",
            "country_code": "US",
            "telephone_number": "609-380-3305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Pauline Dr # 1059",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174024637",
            "country_code": "US",
            "telephone_number": "609-380-3305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNIVERSITY NEURO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "609-380-3305"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Electrodiagnostic Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.