Individual provider Active NPI

Ari Benjamin De Souza

  • Meals Provider
  • Duluth, GA
National Provider Identifier
1760290597
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Meals ProviderTaxonomy code 174200000X
Practice address
1770 Peachtree Industrial Blvd Unit 1112
Duluth, GA 30097-8257
Phone
(954) 552-8183
NPI assigned
Dec 26, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X
Driver 172A00000X
Lodging Provider 177F00000X
Meals Provider 174200000X Primary

Addresses

Primary practice location

1770 Peachtree Industrial Blvd Unit 1112
Duluth, GA 30097-8257

Mailing address

1770 Peachtree Industrial Blvd Unit 1112
Duluth, GA 30097-8257
Phone (954) 552-8183

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

NPI Registry JSON

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1760290597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 PEACHTREE INDUSTRIAL BLVD UNIT 1112",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978257",
            "telephone_number": "954-552-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 PEACHTREE INDUSTRIAL BLVD UNIT 1112",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978257",
            "telephone_number": "954-552-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SOUZA",
        "first_name": "ARI",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.