Vitality Wellness & Pain LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

VITALITY WELLNESS & PAIN LLC

Practice address

5885 Glenridge Dr
Ste 200
Atlanta, GA 30328-5512

Phone

(404) 567-6608

NPI assigned

Oct 6, 2015

Last updated

Jan 29, 2016By 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. Mark C Guerdan, D.O.

Title

Manager/Owner

Phone

(404) 567-6608

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1790155513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 JOHNSON FERRY RD STE 140-107",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421435",
            "telephone_number": "404-567-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 GLENRIDGE DR",
            "address_2": "STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285512",
            "telephone_number": "404-567-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY WELLNESS & PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "GUERDAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "404-567-6608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.