PCA INTERVENTIONAL SPINE AT MACQUARIUM


Address: 1800 Peachtree St Nw, Suite 775, Atlanta, GA 30309-2519
Phone: 4043517654

PCA INTERVENTIONAL SPINE AT MACQUARIUM (NPI# 1053719393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053719393
Entity Type Organization
Organization Name PCA INTERVENTIONAL SPINE AT MACQUARIUM
Practice Address 1800 Peachtree St Nw
Suite 775
Atlanta
GA 30309-2519
Mailing Address 1800 Peachtree St Nw Ste 750
Atlanta
GA 30309-2530
Practice Telephone 4043517654
Practice Fax Number 7706926082
Mailing Telephone 4043517654
Mailing Fax Number 7706926082
Enumeration Date 2014-12-19
Last Update Date 2020-01-08
Authorized Official Name RODRIGO DURALDE (OWNER/MEDICAL DIRECTOR)
Authorized Official Telephone 4043517654
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
Ambulatory Health Care Facilities
Y 261QP3300X Clinic/Center
Specialization: Pain
Ambulatory Health Care Facilities

Office Location

Street Address 1800 PEACHTREE ST NW
SUITE 775
City ATLANTA
State GA
Zip Code 30309-2519

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NPI Name Taxonomy Address Enumeration
1316949571 Elaina Flossie George Specialist 1800 Peachtree St Nw, Suite 650, Atlanta, GA 30309-2519 2005-06-01
1902267206 Meghan Shea Gunter Registered Nurse 1800 Peachtree St Nw, Suite 800, Atlanta, GA 30309-2519 2016-03-14
1346515731 Atlanta Womens Speciality Group II LLC Obstetrics & Gynecology 1800 Peachtree St Nw, Suite 450, Atlanta, GA 30309-2519 2012-03-19
1699917146 David Hobbs Acupuncturist 1800 Peachtree St Nw, Suite 420, Atlanta, GA 30309-2519 2009-03-30
1669614343 Harley Anti-aging Institute LLC Durable Medical Equipment & Medical Supplies 1800 Peachtree St Nw, Suite 455, Atlanta, GA 30309-2519 2009-03-27
1780836494 Inspire Health LLC Clinic/Center 1800 Peachtree St Nw, Suite 420, Atlanta, GA 30309-2519 2008-10-14
1003000308 Keith M Dockery, Md PC Audiologist 1800 Peachtree St Nw, Suite 700, Atlanta, GA 30309-2519 2007-08-29
1811035652 Peachtree Allergy and Asthma Clinic PC Allergy & Immunology 1800 Peachtree St Nw, Suite 720, Atlanta, GA 30309-2519 2007-02-02
1083768691 Peachtree Gynecology, P.C. Obstetrics & Gynecology 1800 Peachtree St Nw, 650, Atlanta, GA 30309-2519 2007-01-22
1477649002 Eleanore E Purser Contractor 1800 Peachtree St Nw, Atlanta, GA 30309-2519 2006-10-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1841782620 Janie Mardis Social Worker 3 Park Ln Ne, Apt H, Atlanta, GA 30309 2018-06-06
1083102842 Veronica L Bentley Specialist/Technologist, Other 1170 Peachtree Street Suite 1200, Atlanta, GA 30309 2018-04-27
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1306377817 Aliyah Lamis Scott Social Worker 1745 Peachtree Road Ne, Kaiser Permanente Brookwood Medical Office, Atlanta, GA 30309 2017-03-26
1013450774 Caroline Hallen Nurse Practitioner 105 Collier Rd Nw Suite 3040, Atlanta, GA 30309 2016-11-29
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Taxonomy Information

Taxonomy Code 261QP3300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Pain

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1659625416 Chiron Medical Services Inc. Clinic/Center 3149 E Shadowlawn Ave Ne, Atlanta, GA 30305-2405 2012-11-01
1144545922 Opulent Wellness LLC Clinic/Center 2221 Peachtree Rd Ne, Ste. P33, Atlanta, GA 30309-1148 2010-04-05
1346403854 The Emory Clinic Inc Clinic/Center 59 Executive Park S, Atlanta, GA 30329-2208 2008-07-03

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1346763190 Laser Spine & Pain Centers LLC Clinic/Center 403 Permian Way Ste C, Villa Rica, GA 30180-3252 2017-07-24
1164828976 Atlanta Pain and Wellness Center PC Clinic/Center 1287 Ga Hwy 138 Spur Ste 8, Jonesboro, GA 30236-2419 2014-11-06
1790031664 Nr Medical Center, LLC Clinic/Center 213 Arrowhead Blvd, Suite D, Jonesboro, GA 30236-1168 2012-07-30
1740566181 Physical Medicine of Norcross Clinic/Center 6315 Spaulding Dr Ste B, Norcross, GA 30092-4653 2011-10-31
1407131899 Cambridge Labs,llc Clinic/Center 611 15th St, Augusta, GA 30901-2601 2011-10-17
1043537905 Primacare Pain & Rehab.,llc Clinic/Center 4467 Glenwood Rd, Suite 2, Decatur, GA 30032-5014 2010-04-30
1194994244 Ernie E Lin Clinic/Center 211 Pleasant Home Road, Suite F-3, Augusta, GA 30907-0559 2008-02-22
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Competitor

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City ATLANTA
Zip Code 30309

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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