NPIMap

Organization Active NPI

Candid Medical Group LLC

  • Pain Clinic/Center
  • Riverdale, GA
National Provider Identifier
1811250244
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
CANDID MEDICAL GROUP LLC
Practice address
6525 Professional PL
Suite C
Riverdale, GA 30274-2519
Phone
(770) 994-1250
Fax
(770) 994-1295
NPI assigned
Jun 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Mr. Bryan Preston Caudill
Title
Managing Partner
Phone
(404) 718-9969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

6525 Professional PL
Suite C
Riverdale, GA 30274-2519

Mailing address

6525 Professional PL
Suite C
Riverdale, GA 30274-2519
Phone (770) 994-1250

National Provider Directory

National Provider Directory
Tax ID family
Candid Medical Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1811250244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 PROFESSIONAL PL",
            "address_2": "SUITE C",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742519",
            "telephone_number": "770-994-1250",
            "fax_number": "770-994-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 PROFESSIONAL PL",
            "address_2": "SUITE C",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742519",
            "telephone_number": "770-994-1250",
            "fax_number": "770-994-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDID MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "404-718-9969",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.