NPIMap

Organization Active NPI

NGX Lawrenceville Ga PC

  • Physical Medicine & Rehabilitation Physician
  • Lawrenceville, GA
National Provider Identifier
1730804642
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
NGX LAWRENCEVILLE GA PC
Practice address
1470 Lawrenceville Hwy
Lawrenceville, GA 30044-4646
Phone
(678) 486-7777
Fax
(678) 486-7777
NPI assigned
Oct 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Richard Graciano
Title
Patient Service Center Manager
Phone
(915) 261-9418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1470 Lawrenceville Hwy
Lawrenceville, GA 30044-4646

Mailing address

1470 Lawrenceville Hwy
Lawrenceville, GA 30044-4646
Phone (678) 486-7777

National Provider Directory

National Provider Directory

Locations

371 E Paces Ferry Rd NE
Ste 802
Atlanta, GA 30305
Phone (404) 618-0995

5749 Wendy Bagwell Pkwy
Hiram, GA 30141
Phone (470) 523-4130

3545 Highway 81 E
McDonough, GA 30252
Phone (678) 486-7777

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1730804642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 LAWRENCEVILLE HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444646",
            "telephone_number": "678-486-7777",
            "fax_number": "678-486-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 LAWRENCEVILLE HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444646",
            "telephone_number": "678-486-7777",
            "fax_number": "678-486-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGX LAWRENCEVILLE GA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "GRACIANO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PATIENT SERVICE CENTER MANAGER",
        "authorized_official_telephone_number": "915-261-9418"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "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 Jan 20, 2023; 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.