Organization Active NPI

Max 360 Health, LLC

  • Physical Medicine & Rehabilitation Physician
  • Alpharetta, GA
National Provider Identifier
1700134913
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
038955 Issued in GA
Legal business name
MAX 360 HEALTH, LLC
Practice address
12315 Crabapple Rd
Suite 144
Alpharetta, GA 30004-6329
Phone
(678) 261-3222
Fax
(678) 261-3226
NPI assigned
Aug 17, 2012
Last updated
Aug 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Authorized official

Name
Mr. Brian Ouellette, D.C.
Title
Owner
Phone
(770) 312-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 038955 GA Primary

Addresses

Primary practice location

12315 Crabapple Rd
Suite 144
Alpharetta, GA 30004-6329

Mailing address

12315 Crabapple Rd
Suite 144
Alpharetta, GA 30004-6329

National Provider Directory

National Provider Directory

Locations

12315 Crabapple Rd
Ste 144
Alpharetta, GA 30004
Phone (678) 261-3222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1700134913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12315 CRABAPPLE RD",
            "address_2": "SUITE 144",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12315 CRABAPPLE RD",
            "address_2": "SUITE 144",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046329",
            "telephone_number": "678-261-3222",
            "fax_number": "678-261-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX 360 HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-312-5005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "038955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.