Organization Active NPI

Mid Physician Network (WV), PLLC

  • General Practice Physician
  • Atlanta, GA
National Provider Identifier
1649703836
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MID PHYSICIAN NETWORK (WV), PLLC
Practice address
5665 New Northside Dr
Suite 520
Atlanta, GA 30328-5831
Phone
(678) 491-2804
NPI assigned
Apr 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Adrian Davis
Title
Ceo
Phone
(678) 491-2804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5665 New Northside Dr
Suite 520
Atlanta, GA 30328-5831

Mailing address

5665 New Northside Dr
Suite 520
Atlanta, GA 30328-5831

National Provider Directory

National Provider Directory
Tax ID family
Mid Physician Network WV PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1649703836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR",
            "address_2": "SUITE 520",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR",
            "address_2": "SUITE 520",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "678-491-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID PHYSICIAN NETWORK (WV), PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-491-2804"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "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 Apr 5, 2017; 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.