Active NPI
Michael Keith Landers, DO
- Specialist
- Atlanta, GA
National Provider Identifier
1013066885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 039617
- Practice address
- 2918 Marlin Cir
Atlanta, GA 30341-5118 - Phone
- (404) 729-9964
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 039617 | GA | Primary |
Addresses
Primary practice location
2918 Marlin Cir
Atlanta, GA 30341-5118
Mailing address
2918 Marlin Cir
Atlanta, GA 30341-5118
Phone (404) 729-9964
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039617 | Other | GA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039617 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1013066885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2918 MARLIN CIR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415118",
"telephone_number": "404-729-9964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2918 MARLIN CIR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415118",
"telephone_number": "404-729-9964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDERS",
"first_name": "MICHAEL",
"middle_name": "KEITH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "039617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "039617",
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.