Provider Type Icon

INNOVATIVE HEALTH CARE INSTITUTE LLC NPI 1942723028


NPI Information

NPI: 1942723028
Provider Name: INNOVATIVE HEALTH CARE INSTITUTE LLC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 11D2190649

Address:
100 SEAGRAVES DR STE 1
ATHENS, GA
ZIP 30605
Phone: (706) 705-2033
Get Directions

INNOVATIVE HEALTH CARE INSTITUTE LLC is an adolescent medicine pediatrics in Athens, GA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. INNOVATIVE HEALTH CARE INSTITUTE LLC NPI is 1942723028. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 SEAGRAVES DR STE 1
ATHENS, GA
ZIP 30605-492
Phone: (706) 705-2033
Fax: (706) 850-8005

The provider's authorized official is Cshanyse Avril Allen .
The authorized official title is Ceo and has the following contact phone number (706) 705-2033.

The CLIA number assigned to this NPI record is 11D2190649 - other - techincal school lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2017 and was last updated on 8/26/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered NurseNo
2163W00000XRegistered NurseRN146812GEORGIANo
32080A0000XPediatricsAdolescent MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.