NPIMap

Organization Active NPI

Proactive Healthcare Solutions, LLC

  • Clinic/Center
  • Conyers, GA
National Provider Identifier
1780958835
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5106 Issued in GA
Legal business name
PROACTIVE HEALTHCARE SOLUTIONS, LLC
Practice address
2434 Wall St SE
Suite a
Conyers, GA 30013-6760
Phone
(770) 679-5515
Fax
(770) 648-6682
NPI assigned
Mar 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Dr. Vincent Veneziano, D.C.
Title
Sole Member
Phone
(678) 602-2569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5106 GA Primary

Addresses

Primary practice location

2434 Wall St SE
Suite a
Conyers, GA 30013-6760

Mailing address

741 Lynn Milam LN
Conyers, GA 30094-4108
Phone (678) 602-2569

National Provider Directory

National Provider Directory

Locations

2434 Wall St SE
Ste A
Conyers, GA 30013
Phone (770) 679-5515

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1780958835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 LYNN MILAM LN",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944108",
            "telephone_number": "678-602-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 WALL ST SE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136760",
            "telephone_number": "770-679-5515",
            "fax_number": "770-648-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HEALTHCARE SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "VENEZIANO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "678-602-2569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "5106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.