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).
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 |
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 |
Street Address |
1800 PEACHTREE ST NW SUITE 775 |
City | ATLANTA |
State | GA |
Zip Code | 30309-2519 |
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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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396382354 | Astoria Dentistry LLC | Dentist | 2233 Peachtree Rd. Nw, Suite 300, Atlanta, GA 30309 | 2019-12-09 |
1487133740 | S2 Telehealth Technologies, LLC | Psychiatry & Neurology | 915 W Peachtree St Nw Apt 522, Atlanta, GA 30309 | 2018-08-08 |
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 |
1427566363 | Net Medical Corp | Chiropractor | 1100 Spring St Sw, Ste#700, Atlanta, GA 30309 | 2018-01-12 |
1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
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 |
1528501723 | Ant-aging Queen | Nutritionist | 1801 Atlanta Medical Clinic, Suite 250, Atlanta, GA 30309 | 2016-11-21 |
1790231439 | Nurse 2 Health Home Care LLC | Home Health | 1075 Peachtree Street Ne, Atlanta, GA 30309 | 2016-09-01 |
Find all providers in zip 30309 |
Taxonomy Code | 261QP3300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Pain |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700287232 | Siesta Anesthesia Services, LLC | Clinic/Center | 100 Hartsfield Center Pkwy, Suite 500, Atlanta, GA 30354-1341 | 2014-09-16 |
1154761385 | Georgia Wellness Associates | Clinic/Center | 552 Ponce De Leon Ave Ne, Atlanta, GA 30308-1806 | 2013-07-02 |
1457690554 | Georgia Pain and Wellness, LLC | Clinic/Center | 552 Ponce De Leon Ave Ne, Atlanta, GA 30308-1806 | 2013-02-08 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558970640 | Fx Spine and Performance Center, LLC | Clinic/Center | 106 Srp Dr Ste B, Evans, GA 30809-4358 | 2020-07-24 |
1083253140 | Intercare Medical, Corp | Clinic/Center | 3540 Wheeler Rd Ste 307, Augusta, GA 30909-1887 | 2020-01-06 |
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 |
1235354218 | Acworth Pain Management Center Inc | Clinic/Center | 5399 Bells Ferry Rd, Suite 180, Acworth, GA 30102-7546 | 2007-04-16 |
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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.