Sacred Heart Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

39501 Issued in GA

Legal business name

SACRED HEART MEDICAL CLINIC LLC

Practice address

3146 Chamblee Dunwoody Rd Ste 103
Chamblee, GA 30341-2967

Phone

(678) 530-0877

Fax

(678) 530-0700

NPI assigned

Jan 10, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Franklin Theodore Von Hack-Prestinary, MD

Title

Medical Director

Phone

(678) 530-0877

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1699197582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 CHAMBLEE DUNWOODY RD STE 103",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412967",
            "telephone_number": "678-530-0877",
            "fax_number": "678-530-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 CHAMBLEE DUNWOODY RD STE 103",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412967",
            "telephone_number": "678-530-0877",
            "fax_number": "678-530-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "VON HACK-PRESTINARY",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-530-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "39501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Chamblee, GA
• Providers in Chamblee, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.