NPIMap

Organization Active NPI

Advanced Medical Weight Loss Center

  • Allergy Physician
  • Atlanta, GA
National Provider Identifier
1922412683
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
ADVANCED MEDICAL WEIGHT LOSS CENTER
Practice address
1100 Spring St NW
Suite 150
Atlanta, GA 30309-2846
Phone
(678) 294-0444
NPI assigned
Jun 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Jennifer Jane Clark
Title
Owner
Phone
(678) 294-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X Primary

Addresses

Primary practice location

1100 Spring St NW
Suite 150
Atlanta, GA 30309-2846

Mailing address

1490 Lane Creek Rd
Bogart, GA 30622-2627
Phone (678) 294-0444

National Provider Directory

National Provider Directory

Locations

1100 Spring St NW
Ste 150
Atlanta, GA 30309
Phone (404) 815-1505

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1922412683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 LANE CREEK RD",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306222627",
            "telephone_number": "678-294-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SPRING ST NW",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092846",
            "telephone_number": "678-294-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL WEIGHT LOSS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-294-0444"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "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 Jun 19, 2014; 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.