International Community Medical Network, LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

INTERNATIONAL COMMUNITY MEDICAL NETWORK, LLC

Practice address

1900 Windsor Dr SW
Atlanta, GA 30311-4414

Phone

(559) 455-3934

NPI assigned

Jun 28, 2013

Last updated

Jun 28, 2013By 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

Kwame Makini

Title

Ceo

Phone

(559) 455-3934

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1750721221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WINDSOR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303114414",
            "telephone_number": "559-455-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WINDSOR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303114414",
            "telephone_number": "559-455-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL COMMUNITY MEDICAL NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "MAKINI",
        "authorized_official_first_name": "KWAME",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-455-3934"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health & General Preventive Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Public Health & General Preventive Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.