NPIMap

Organization Active NPI

Waterworksnow, Incorporated

  • Health Service Clinic/Center
  • Stone Mountain, GA
National Provider Identifier
1972036978
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
48419 Issued in GA
Legal business name
WATERWORKSNOW, INCORPORATED
Practice address
1525 E Park Place Blvd
Suite 1800
Stone Mountain, GA 30087-3453
Phone
(678) 558-6767
NPI assigned
Apr 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Dr. Cynthia Goodman, M.D.NPI 1477795268
Title
Ceo/President
Phone
67855886767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 48419 GA Primary
Medical Specialty Clinic/Center 261QM2500X 48419 GA
Physical Therapy Clinic/Center 261QP2000X 48419 GA
Research Clinic/Center 261QR1100X 48419 GA

Addresses

Primary practice location

1525 E Park Place Blvd
Suite 1800
Stone Mountain, GA 30087-3453

Mailing address

PO Box 370354
Decatur, GA 30037-0354
Phone (678) 558-6767

National Provider Directory

National Provider Directory

Locations

1525 E Park Place Blvd
Ste 1800
Stone Mountain, GA 30087
Phone (678) 558-6767

Practitioners & affiliated clinicians

Practitioners 1

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": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1972036978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370354",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300370354",
            "telephone_number": "678-558-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E PARK PLACE BLVD",
            "address_2": "SUITE 1800",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873453",
            "telephone_number": "678-558-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERWORKSNOW, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "67855886767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "GA",
            "license": "48419",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "48419",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "48419",
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": "GA",
            "license": "48419",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.