Organization Active NPI

Atlanta Internal Medicine and Psychiatric Care

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1003174624
Registry record updated Aug 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ATLANTA INTERNAL MEDICINE AND PSYCHIATRIC CARE
Practice address
3915 Cascade Rd SW Ste 360
Atlanta, GA 30331-8533
Phone
(678) 973-2370
Fax
(470) 819-4995
NPI assigned
May 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gregory C Lunceford, M.D.NPI 1851373047
Title
Ceo
Phone
(770) 396-0232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3915 Cascade Rd SW Ste 360
Atlanta, GA 30331-8533

Mailing address

3915 Cascade Rd SW Ste 360
Atlanta, GA 30331-8533
Phone (770) 317-7300

Other identifiers 2

IdentifierTypeStateIssuer
003125640AMedicaidGA
REF000549852MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120507000511 GA Part B Supplier - Clinic/Group Practice 4183886245 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725062400000",
    "number": "1003174624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 360",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318533",
            "telephone_number": "770-317-7300",
            "fax_number": "470-819-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 360",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318533",
            "telephone_number": "678-973-2370",
            "fax_number": "470-819-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA INTERNAL MEDICINE AND PSYCHIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2024-08-31",
        "certification_date": "2024-08-31",
        "status": "A",
        "authorized_official_last_name": "LUNCEFORD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-396-0232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125640A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "REF000549852",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.