NPIMap

Individual provider Active NPI

Alan M Harben, M.D.,PHD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Roswell, GA
National Provider Identifier
1669652095
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
029664 Issued in GA
Practice address
11775 Pointe Place
Suite 103
Roswell, GA 30076-4652
Phone
(770) 619-0010
Fax
(770) 664-6511
NPI assigned
Nov 14, 2007
Last updated
Dec 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 029664 GA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 029664 GA Primary

Addresses

Primary practice location

11775 Pointe Place
Suite 103
Roswell, GA 30076-4652

Mailing address

11775 Pointe PL
Suite 103
Roswell, GA 30076-4655
Phone (770) 619-0010

Other identifiers 2

IdentifierTypeStateIssuer
00349137CMedicaidGA
00349137IMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000338 GA Practitioner - Physical Medicine and Rehabilitation 0840262531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Georgia School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11775 Pointe PL
Suite 103
Roswell, GA 30076-4652
Phone (770) 619-0010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
029664GAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alan M Harben MD PHD Pain Medicine Current Accepting new patients

Locations

11775 Pointe Pl
Ste 103
Roswell, GA 30076
Phone (404) 500-7378

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1669652095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11775 POINTE PL",
            "address_2": "SUITE 103",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764655",
            "telephone_number": "770-619-0010",
            "fax_number": "770-664-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11775 POINTE PLACE",
            "address_2": "SUITE 103",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764652",
            "telephone_number": "770-619-0010",
            "fax_number": "770-664-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBEN",
        "first_name": "ALAN",
        "middle_name": "M",
        "credential": "M.D.,PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "029664",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "029664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00349137C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00349137I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.