Ips of Forest Park LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

IPS OF FOREST PARK LLC

Practice address

541 Forest Pkwy
Ste 14
Forest Park, GA 30297-6144

Phone

(404) 366-5652

NPI assigned

May 22, 2009

Last updated

May 22, 2009By 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

Carl R Noback, MD

Title

Member

Phone

(941) 360-1566

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1770718538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864483",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328864483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 FOREST PKWY",
            "address_2": "STE 14",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976144",
            "telephone_number": "404-366-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPS OF FOREST PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "NOBACK",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "941-360-1566",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devona Hollingsworth, LAT, ATC, CES
• Kristina Howell
• Paola Hoyo Figueroa, DC
• Niambi Ibim, OTR/L
• Integrated Health and Wellness Solutions
• Rose M James, DPM
• Charles Jenkins III, APRN
• Amisa Jiwani, APRN
• Xavier Johnson, NCTMB, CMT, CMMT
• Michael Reu Johnston, D.C.

• Anesthesiology Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.