NPIMap

Organization Active NPI

Premier Aesthetics

  • Specialist
  • Lithonia, GA
National Provider Identifier
1780968115
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
08518 Issued in GA
Legal business name
PREMIER AESTHETICS
Practice address
5404 Hillandale Park CT
Lithonia, GA 30058-8803
Phone
(678) 418-6990
Fax
(678) 418-6986
NPI assigned
Oct 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Angela Copeland, CPC
Title
Practice Manager
Phone
(678) 689-6485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 08518 GA Primary

Addresses

Primary practice location

5404 Hillandale Park CT
Lithonia, GA 30058-8803

Mailing address

5404 Hillandale Park CT
Lithonia, GA 30058-8803
Phone (678) 418-6990

National Provider Directory

National Provider Directory

Locations

5404 Hillandale Park Ct
Lithonia, GA 30058
Phone (678) 418-6990

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1780968115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 HILLANDALE PARK CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300588803",
            "telephone_number": "678-418-6990",
            "fax_number": "678-418-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 HILLANDALE PARK CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300588803",
            "telephone_number": "678-418-6990",
            "fax_number": "678-418-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "678-689-6485",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "08518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.