Progressive Medical Clinic LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PROGRESSIVE MEDICAL CLINIC LLC

Practice address

2098 Teron Trce Ste 300
Dacula, GA 30019-1667

Phone

(770) 614-4060

Fax

(678) 482-7788

NPI assigned

Dec 9, 2020

Organization subpart

No

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

Authorized official

Name

Benjamin MitchellNPI 1417091471

Title

Owner

Phone

(770) 614-4060

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Caughey Mitchell, D.C.

  • Rehabilitation Chiropractor
  • Dacula, GA
  • NPI 1417091471
  NPD Authorized official

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1992301402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 TERON TRCE STE 300",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191667",
            "telephone_number": "770-614-4060",
            "fax_number": "678-482-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 TERON TRCE STE 300",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191667",
            "telephone_number": "770-614-4060",
            "fax_number": "678-482-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-614-4060"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie N Prasad-Dehaney, NBC-HWC
• Precision Vital Group Care LLC
• Carla M Price, M.D.
• Prime Veritas
• Meg M Primm
• Proskills Home Health Care Services
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• Protherapy Inc
• Gloicie Darlene Pruitt, PT
• Lacey Daniel Pruitt

• Adult Medicine Physician in Dacula, GA
• Providers in Dacula, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.