Jeremy Meisel MD LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

052786 Issued in GA

Legal business name

JEREMY MEISEL MD LLC

Doing business as

Advanced Neurology Center

Practice address

4904 Timber Ridge Dr
Suite 305
Douglasville, GA 30135-1828

Phone

(678) 501-5420

Fax

(678) 501-5429

NPI assigned

Aug 20, 2013

Last updated

Nov 17, 2014By 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

Dr. Jeremy Meisel, M.D.NPI 1679513865

Title

Owner

Phone

(678) 501-5420

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Neurology Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Jeremy Neil Meisel, MD

  • Neurology Physician
  • Atlanta, GA
  • NPI 1679513865
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1790118131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 MONROE DR NE STE F",
            "address_2": "SUITE F602",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245022",
            "telephone_number": "678-501-5420",
            "fax_number": "678-501-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 TIMBER RIDGE DR",
            "address_2": "SUITE 305",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351828",
            "telephone_number": "678-501-5420",
            "fax_number": "678-501-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY MEISEL MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "MEISEL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-501-5420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "052786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612935883D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Neurology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neurology Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.