NPIMap

Organization Active NPI

Prohealth Spinal and Rehab Center

  • Clinic/Center
  • Lawrenceville, GA
National Provider Identifier
1740530195
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
007116 Issued in GA
Legal business name
PROHEALTH SPINAL AND REHAB CENTER
Practice address
1860 Atkinson Rd Ste 116
Lawrenceville, GA 30043-5066
Phone
(770) 876-6972
Fax
(770) 452-2844
NPI assigned
Sep 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Abdo Ibrahim, DC
Title
Physician
Phone
(770) 876-6972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 007116 GA Primary

Addresses

Primary practice location

1860 Atkinson Rd Ste 116
Lawrenceville, GA 30043-5066

Mailing address

1860 Atkinson Rd Ste 116
Lawrenceville, GA 30043-5066
Phone (770) 876-6972

National Provider Directory

National Provider Directory

Locations

1860 Atkinson Rd
Ste 116
Lawrenceville, GA 30043
Phone (770) 876-6972

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1740530195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 ATKINSON RD STE 116",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435066",
            "telephone_number": "770-876-6972",
            "fax_number": "770-452-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 ATKINSON RD STE 116",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435066",
            "telephone_number": "770-876-6972",
            "fax_number": "770-452-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH SPINAL AND REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ABDO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-876-6972",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "007116",
            "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 Sep 13, 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.