Iceberg Health LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ICEBERG HEALTH LLC

Practice address

1670 McKendree Church Rd Ste 400B
Lawrenceville, GA 30043-4100

Phone

(678) 985-0444

Fax

(678) 878-2330

NPI assigned

Sep 24, 2019

Organization subpart

Yes

Parent organization

JUST HEALTH LLCAs reported in NPPES

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

Authorized official

Name

Tonya Culp, CMRS

Title

Director of Revenue Cycle

Phone

(770) 971-8115

Specialties & licenses 1

Addresses

Other names 1

• Just Health LLC Former legal business name

Part of

Just Health LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Just Health LLC

  • Chiropractor
  • Lawrenceville, GA
  • NPI 1801258876
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamlesh Ramji Patel, D.C.

  • Chiropractor
  • Lawrenceville, GA
  • NPI 1538430202
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1720639461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 MCKENDREE CHURCH RD STE 400B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434100",
            "telephone_number": "678-985-0444",
            "fax_number": "678-878-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 MCKENDREE CHURCH RD STE 400B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434100",
            "telephone_number": "678-985-0444",
            "fax_number": "678-878-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Shawnee Trl SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300677316",
            "country_code": "US",
            "telephone_number": "770-971-8115",
            "fax_number": "678-878-2330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "697 Ruskin Dr",
            "address_purpose": "LOCATION",
            "city": "Forest Park",
            "state": "GA",
            "postal_code": "302971077",
            "country_code": "US",
            "telephone_number": "404-955-7246",
            "fax_number": "678-878-2330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICEBERG HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JUST HEALTH LLC",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "CULP",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "770-971-8115",
        "authorized_official_credential": "CMRS"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Just Health LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Chiropractor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.