Individual provider Active NPI

Eric Scott Traub, MS, CGC

  • Genetic Counselor (M.S.)
  • Atlanta, GA
National Provider Identifier
1669948097
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
Practice address
1100 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-1740
Phone
(404) 851-6284
Fax
(404) 303-3873
NPI assigned
Oct 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 412 GA
Genetic Counselor (M.S.) 170300000X Primary

Addresses

Primary practice location

1100 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-1740

Mailing address

1100 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-1740
Phone (404) 851-6284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
412GAMDGenetic Counselor (M.S.)

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1669948097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421740",
            "telephone_number": "404-851-6284",
            "fax_number": "404-303-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421740",
            "telephone_number": "404-851-6284",
            "fax_number": "404-303-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUB",
        "first_name": "ERIC",
        "middle_name": "SCOTT",
        "credential": "MS, CGC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-24",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "GA",
            "license": "412",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "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 Jan 16, 2025; 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.