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PROGRESSIVE MEDICAL CLINIC LLC
NPI 1992301402
Family Medicine - Adult Medicine in Dacula, GA

Active since December 09, 2020
2098 TERON TRCE STE 300, DACULA, GA 30019(770) 614-4060(678) 482-7788 Get Directions Write a Review

NPPES record last updated: February 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 19, 2021, Dec 9, 2020 (2 updates tracked since 2020).

About Progressive Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROGRESSIVE MEDICAL CLINIC LLC (NPI 1992301402) is a healthcare organization registered as an adult medicine in Dacula, Georgia and active in the NPI registry since December 2020. The organization lists Benjamin Mitchell, Owner, as its authorized official.

NPPES Registry Identity

NPI1992301402
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NamePROGRESSIVE MEDICAL CLINIC LLC
Location Address2098 TERON TRCE STE 300Dacula, GA 30019-1667
Mailing Address2098 Teron Trce Ste 300Dacula, GA 30019-1667 · (770) 614-4060 · Fax (678) 482-7788
Phone(770) 614-4060
Fax(678) 482-7788
Organization SubpartNo
Authorized OfficialBenjamin MitchellOwner · (770) 614-4060
Enumeration DateDecember 9, 2020
Last NPPES UpdateFebruary 19, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2021
✔ NPI 1992301402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedGeneral PracticeTaxonomy 208D00000X
2098 TERON TRCE STE 300, Dacula, GA 30019
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LANNY BRIAN LIGHTFOOT M.S.
Specialist/Technologist (Athletic Trainer)
2098 TERON TRCE STE 300
DACULA, GA 30019
Gwinnett County (770) 614-4060
KIMBERLY FARR NP
Nurse Practitioner (Adult Health)
2098 TERON TRCE STE 300
DACULA, GA 30019
Gwinnett County (770) 614-4060
DEBBIE MORRIS DURAND
Counselor (Professional)
2098 TERON TRCE STE 300
DACULA, GA 30019
Gwinnett County (404) 431-9895

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Progressive Medical Clinic LLC's NPI number?

The NPI number for Progressive Medical Clinic LLC is 1992301402. It was assigned to this organization in the NPPES registry on December 9, 2020.

Where is Progressive Medical Clinic LLC located?

Progressive Medical Clinic LLC is located at 2098 Teron Trce Ste 300, Dacula, GA 30019. The listed phone number is (770) 614-4060.

What is Progressive Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Progressive Medical Clinic LLC was last updated on February 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.