Midtown West Medical, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

GA32213 Issued in GA

Legal business name

MIDTOWN WEST MEDICAL, PC

Practice address

957 W Marietta St NW
Atlanta, GA 30318-5282

Phone

(404) 817-0062

Fax

(404) 817-0064

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Kimball A Johnson, M.D.

Title

Owner

Phone

(404) 817-0062

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1689736654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 W MARIETTA ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185282",
            "telephone_number": "404-817-0062",
            "fax_number": "404-817-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 W MARIETTA ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185282",
            "telephone_number": "404-817-0062",
            "fax_number": "404-817-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN WEST MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMBALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-817-0062",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "GA32213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "11D1012816",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "495960",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midtown Surgical Associates, Inc
• Midtown Urology Anesthesia LLC
• Midtown Urology PC
• Midtown Urology Surgical Center, PC
• Midtown Wellness Group, Inc.
• Midwest Compression, LLC
• Midwest Medical Associates, Inc.
• Midwest Medical DME Enterprises, LLC
• Midwest Medical DME Services, LLC
• Midwest Medical Enterprises, LLC

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.