Nupath Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NUPATH MEDICAL LLC

Practice address

2098 Town Manor CT
Dacula, GA 30019-3247

Phone

(770) 776-9417

NPI assigned

Jan 22, 2020

Last updated

Jan 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Lackey

Title

President

Phone

(770) 776-9417

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1740810407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 TOWN MANOR CT",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 TOWN MANOR CT",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193247",
            "telephone_number": "770-776-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUPATH MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-776-9417"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STREET ADDRESS",
            "identifier": "2098",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick@nupathmed.com",
            "affiliation": "N",
            "address_1": "2098 Town Manor Ct",
            "city": "Dacula",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300193247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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