NPIMap

Organization Active NPI

Neighbormd of Atlanta LLC

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1902407752
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NEIGHBORMD OF ATLANTA LLC
Practice address
285 Boulevard NE Ste 435&436
Atlanta, GA 30312-4205
Phone
(404) 222-9914
Fax
(404) 524-5902
NPI assigned
Nov 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
David Romanello
Title
Coo
Phone
(352) 459-3661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

285 Boulevard NE Ste 435&436
Atlanta, GA 30312-4205

Mailing address

285 Boulevard NE Ste 435&436
Atlanta, GA 30312-4205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210805001965 GA Part B Supplier - Clinic/Group Practice 1153725668 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
Practice locations: Newnan, GA; Tucker, GA; Atlanta, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Neighbormd of Atlanta LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

285 Boulevard NE
Ste 435436
Atlanta, GA 30312

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1902407752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD NE STE 435&436",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD NE STE 435&436",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124205",
            "telephone_number": "404-222-9914",
            "fax_number": "404-524-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORMD OF ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "ROMANELLO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "352-459-3661"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.