NPIMap

Organization Active NPI

Rediclinic LLC

  • Clinic/Center
  • Lawrenceville, GA
National Provider Identifier
1710055173
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REDICLINIC LLC
Practice address
2990 Five Forks Trickum Rd
Lawrenceville, GA 30044-5872
Phone
(713) 935-0333
NPI assigned
Dec 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rick Vanpelt
Title
VP of Operations
Phone
(866) 935-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2990 Five Forks Trickum Rd
Lawrenceville, GA 30044-5872

Mailing address

18059 Crescent Royale Way
Humble, TX 77346-3467
Phone (866) 935-0333

National Provider Directory

National Provider Directory
Tax ID family
Rediclinic18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710055173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18059 CRESCENT ROYALE WAY",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463467",
            "telephone_number": "866-935-0333",
            "fax_number": "713-935-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 FIVE FORKS TRICKUM RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445872",
            "telephone_number": "713-935-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANPELT",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "866-935-0333"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.