NPIMap

Organization Active NPI

Whole Family Medicine, LLC

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1053589481
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WHOLE FAMILY MEDICINE, LLC
Practice address
402 W Ponce de Leon Ave
Decatur, GA 30030-2443
Phone
(404) 377-9010
Fax
(404) 935-0254
NPI assigned
Feb 19, 2008
Last updated
Jun 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Dr. Marion Kaylor Owen, M.D.NPI 1376586347
Title
President
Phone
(404) 395-7845

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

402 W Ponce de Leon Ave
Decatur, GA 30030-2443

Mailing address

402 W Ponce de Leon Ave
Decatur, GA 30030-2443
Phone (404) 377-9010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080219000191 GA Part B Supplier - Clinic/Group Practice 0345323093 Receives reassigned benefits from 2 practitioners
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory

Locations

402 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 377-9010

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1053589481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302443",
            "telephone_number": "404-377-9010",
            "fax_number": "404-935-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302443",
            "telephone_number": "404-377-9010",
            "fax_number": "404-935-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "KAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-395-7845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.