Jeannie-in-a-Bottle LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

041517 Issued in GA

Legal business name

JEANNIE-IN-A-BOTTLE LLC

Practice address

3620 Howell Ferry Rd
Duluth, GA 30096-3178

Phone

(678) 312-6800

Fax

(678) 312-5622

NPI assigned

Aug 5, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Jeannie M Blom, M.D.

Title

Ceo

Phone

(404) 849-3443

Specialties & licenses 1

Addresses

Other names 1

• Jeannie Blom Other name

Locations

Practitioners 1

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

• John Robert Stephenson, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1700980216
  NPD (past)

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1871759233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 CANTON RD STE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666079",
            "telephone_number": "866-214-8600",
            "fax_number": "678-888-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 HOWELL FERRY RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963178",
            "telephone_number": "678-312-6800",
            "fax_number": "678-312-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE-IN-A-BOTTLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "BLOM",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-849-3443",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "041517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeannie Blom",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jaslinks Hospice Inc
• Jason M. Campbell DDS Inc.
• Jay B Bender
• Joan Eileen Jay, CRNA
• Badrinath Jayanthi
• Talitha Mylia Jeffrey
• Brittney Nicole Jeffrie
• Pamelarenee Renee Jemerson, LCSW
• Alana Jenkins
• Jessica Jenkins, CSW008049

• Physical Medicine & Rehabilitation Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.