| NPI | 1407877764 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-07-22 |
| Last Updated | 2011-12-13 |
| Authorized Official | Quatoya Tyson Clinical Office Coordinator Phone: 4046071002 |
| Mailing Address | Po Box 54723 Atlanta, GA 30308 United States Phone: (404) 607-1002 | Fax: (404) 607-1031 📍 View Map |
| Primary Practice Address | 494 Boulevard Se Atlanta, GA 30312-3426 United States Phone: (404) 607-1002 | Fax: (404) 607-1031 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | GA | 229783620B | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 261Q00000X – Clinic/Center | GA | - |
| Yes | 207QA0505X – Family Medicine, Adult Medicine | - | - |
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About NPI 1407877764
Progressive Community Healthcare is an organization registered in the CMS NPPES NPI Registry with NPI number 1407877764. The primary specialty listed is Family Medicine, Adult Medicine. The organization is located in Atlanta, GA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-22. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1407877764?
NPI 1407877764 belongs to Progressive Community Healthcare, a Family Medicine, Adult Medicine in Atlanta, GA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1407877764 active?
The current status of NPI 1407877764 in the NPPES registry is Active. The record was last updated on 2011-12-13.
What specialty is NPI 1407877764?
NPI 1407877764 is classified under the taxonomy Family Medicine, Adult Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1407877764?
You can verify NPI 1407877764 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1407877764?
The primary practice address on file for NPI 1407877764 is 494 Boulevard Se, Atlanta, GA 30312-3426. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1407877764 issued?
NPI 1407877764 was first issued (enumerated) on 2006-07-22. The NPPES record was last updated on 2011-12-13.
Practice Location Map
Progressive Community Healthcare is located at 494 Boulevard Se, Atlanta, GA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Progressive Community Healthcare. All records sourced from the CMS NPPES registry.