Atlanta Central Medical Group, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ATLANTA CENTRAL MEDICAL GROUP, INC.

Practice address

2400 Pleasant Hill Rd
300
Duluth, GA 30096-4396

Phone

(678) 467-9882

NPI assigned

Nov 10, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Kuy Ik Park

Title

Ceo

Phone

(678) 467-9882

Specialties & licenses 5

Addresses

Other names 1

• Central medical Group Other name

Locations

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1912284480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 BEAVER BR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714579",
            "telephone_number": "678-467-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PLEASANT HILL RD",
            "address_2": "300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964396",
            "telephone_number": "678-467-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA CENTRAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "KUY IK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-467-9882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.