NPIMap

Organization Active NPI

NGDC Sleep Med Lab

  • Durable Medical Equipment & Medical Supplies
  • Gainesville, GA
National Provider Identifier
1720228653
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
40404 Issued in GA
Legal business name
NGDC SLEEP MED LAB
Practice address
1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone
(770) 536-9864
Fax
(770) 297-5023
NPI assigned
Mar 5, 2009
Last updated
Sep 20, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
NE GA DIAGNOSTIC CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Authorized official

Name
Dr. Wesley D Head, MDNPI 1487657508
Title
Director
Phone
(770) 536-9864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 40404 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862

Mailing address

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone (770) 536-9864

Other identifiers 1

IdentifierTypeStateIssuer
51000159001OtherGABCBS Q CARE NUMBER

National Provider Directory

National Provider Directory
Part of
N E Ga Diag Clinci LLC

Practitioners & affiliated clinicians

Practitioners 9

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": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1720228653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGDC SLEEP MED LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NE GA DIAGNOSTIC CLINIC LLC",
        "enumeration_date": "2009-03-05",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-536-9864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "40404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS Q CARE NUMBER",
            "identifier": "51000159001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.