NPIMap

Organization Active NPI

Modern Emergent Care, LLC

  • Emergency Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1962820845
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
MODERN EMERGENT CARE, LLC
Practice address
5505 Roswell Rd
Suite 100
Atlanta, GA 30342-1985
Phone
(404) 334-3000
Fax
(478) 333-6117
NPI assigned
Mar 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Authorized official

Name
Raymond Elias Gutierrez, M.D.
Title
Medical Director
Phone
(770) 557-4220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

5505 Roswell Rd
Suite 100
Atlanta, GA 30342-1985

Mailing address

5505 Roswell Rd
Suite 100
Atlanta, GA 30342-1985
Phone (404) 334-3000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1962820845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 ROSWELL RD",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421985",
            "telephone_number": "404-334-3000",
            "fax_number": "478-333-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 ROSWELL RD",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421985",
            "telephone_number": "404-334-3000",
            "fax_number": "478-333-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN EMERGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "ELIAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-557-4220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "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 Jan 15, 2015; 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.