Mt Vernon OB/GYN, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

019640 Issued in GA

Legal business name

MT VERNON OB/GYN, LLC

Practice address

755 Mount Vernon Hwy NE
#330
Atlanta, GA 30328-4274

Phone

(404) 256-2277

NPI assigned

Jul 5, 2006

Last updated

Dec 5, 2007By 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

Stephen C Blank, MDNPI 1619902293

Title

Owner

Phone

(404) 256-2277

Specialties & licenses 1

Addresses

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.

• Stephen C Blank, MD

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1619902293
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1811928054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 BRECKINRIDGE BLVD",
            "address_2": "SUITE 120",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967611",
            "telephone_number": "678-226-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MOUNT VERNON HWY NE",
            "address_2": "#330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284274",
            "telephone_number": "404-256-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON OB/GYN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-256-2277",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "019640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.