Active NPI
Jesus Caballero
- Clinical Medical Laboratory
- Atlanta, GA
National Provider Identifier
1740998079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 11D0551
- Practice address
- 5 Concourse Pkwy Ste 3000
Atlanta, GA 30328-7106 - Phone
- (770) 901-7130
- NPI assigned
- Nov 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 11D0551 | GA | Primary |
Addresses
Primary practice location
5 Concourse Pkwy Ste 3000
Atlanta, GA 30328-7106
Mailing address
5 Concourse Pkwy Ste 3000
Atlanta, GA 30328-7106
Phone (770) 901-7130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11D0551 | GA | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1740998079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 CONCOURSE PKWY STE 3000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303287106",
"telephone_number": "770-901-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CONCOURSE PKWY STE 3000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303287106",
"telephone_number": "770-901-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABALLERO",
"first_name": "JESUS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-07",
"last_updated": "2022-11-07",
"certification_date": "2022-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "GA",
"license": "11D0551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.