Live Oak Neurology LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

LIVE OAK NEUROLOGY LLC

Practice address

850 Dogwood Rd Ste B2002002
Lawrenceville, GA 30044-7218

Phone

(404) 900-9540

NPI assigned

Nov 13, 2018

Organization subpart

No

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

Authorized official

Name

Doreen Shinn

Title

VP

Phone

(609) 380-3305

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1861961427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 DOGWOOD RD STE B2002002",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 DOGWOOD RD STE B2002002",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447218",
            "telephone_number": "404-900-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "609-380-3305"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Electrodiagnostic Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Electrodiagnostic Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.