Synergistix Universal LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

SYNERGISTIX UNIVERSAL LLC

Practice address

3522 Habersham at Northlake Ste B
Tucker, GA 30084-4009

Phone

(901) 606-7966

NPI assigned

Mar 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Alexcius BranchNPI 1972189017

Title

Ceo

Phone

(901) 606-7966

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexcius Branch

  • Pastoral Counselor
  • Tucker, GA
  • NPI 1972189017

  Community Health Worker

  NPD Authorized official

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1841876992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 HABERSHAM AT NORTHLAKE STE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 HABERSHAM AT NORTHLAKE STE B",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844009",
            "telephone_number": "901-606-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGISTIX UNIVERSAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "BRANCH",
        "authorized_official_first_name": "ALEXCIUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-606-7966",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH/MULTI-SERVICE",
            "identifier": "813319",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH/MULTI-SERVICE",
            "identifier": "624120",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community Health Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Community Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.