National Telewound Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

033908 Issued in GA

Legal business name

NATIONAL TELEWOUND CARE

Practice address

374 Osprey PT
Stone Mountain, GA 30087-6163

Phone

(678) 404-5631

Fax

(877) 210-5143

NPI assigned

Oct 11, 2012

Organization subpart

No

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

Authorized official

Name

Diane Alexander

Title

Secretary

Phone

(678) 371-2204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1942552146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 OSPREY PT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876163",
            "telephone_number": "678-404-5631",
            "fax_number": "877-210-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OSPREY PT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876163",
            "telephone_number": "678-404-5631",
            "fax_number": "877-210-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL TELEWOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "678-371-2204"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "033908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.