NPIMap

Organization Active NPI

Preventive Medicine Anti-Aging and Chelation, Inc

  • Point of Service
  • Sandy Springs, GA
National Provider Identifier
1972541670
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
046372 Issued in GA
Legal business name
PREVENTIVE MEDICINE ANTI-AGING AND CHELATION, INC
Practice address
171 Mount Paran Rd NE
Sandy Springs, GA 30342-2211
Phone
(706) 891-1200
Fax
(706) 891-1202
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Dr. Robert A Burkich, M.D.NPI 1811936891
Title
Director
Phone
(706) 891-1200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 046372 GA Primary

Addresses

Primary practice location

171 Mount Paran Rd NE
Sandy Springs, GA 30342-2211

Mailing address

148 Cobb Pkwy
Ringgold, GA 30736-8566
Phone (706) 891-1200

National Provider Directory

National Provider Directory

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1972541670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 COBB PKWY",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307368566",
            "telephone_number": "706-891-1200",
            "fax_number": "706-891-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MOUNT PARAN RD NE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303422211",
            "telephone_number": "706-891-1200",
            "fax_number": "706-891-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ANTI-AGING AND CHELATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "BURKICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "706-891-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "046372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.