Organization Active NPI

Neuro Diagnostic Group LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Atlanta, GA
National Provider Identifier
1760900708
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
59870 Issued in GA
Legal business name
NEURO DIAGNOSTIC GROUP LLC
Practice address
200 Galleria Pkwy SE Ste 100
Atlanta, GA 30339-5944
Phone
(855) 411-2225
Fax
(800) 886-1731
NPI assigned
Aug 30, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Offer Danan, DCNPI 1598009342
Title
Ceo
Phone
(770) 695-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 59870 GA Primary

Addresses

Primary practice location

200 Galleria Pkwy SE Ste 100
Atlanta, GA 30339-5944

Mailing address

200 Galleria Pkwy SE Ste 100
Atlanta, GA 30339-5944
Phone (855) 411-2225

Other identifiers 1

IdentifierTypeStateIssuer
1679765523OtherGANEUROLOGY

National Provider Directory

National Provider Directory

Locations

200 Galleria Pkwy SE
Ste 100
Atlanta, GA 30339
Phone (770) 444-0076

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760900708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GALLERIA PKWY SE STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395944",
            "telephone_number": "855-411-2225",
            "fax_number": "800-886-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GALLERIA PKWY SE STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395944",
            "telephone_number": "855-411-2225",
            "fax_number": "800-886-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO DIAGNOSTIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DANAN",
        "authorized_official_first_name": "OFFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-695-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "59870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEUROLOGY",
            "identifier": "1679765523",
            "state": "GA"
        }
    ],
    "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 Jul 21, 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.

Verify at the official NPI Registry.