Active NPI
Matthieu Laliberte, MD
- Family Medicine Physician
- Jonesboro, GA
National Provider Identifier
1104134295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 064850
- Practice address
- 2400 Mount Zion Parkway
Kaiser Permanente Southwood Medical Center
Jonesboro, GA 30236 - Phone
- (770) 603-3577
- NPI assigned
- Sep 22, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 064850 | GA | Primary |
| Family Medicine Physician | 207Q00000X | 64850 | GA |
Addresses
Primary practice location
2400 Mount Zion Parkway
Kaiser Permanente Southwood Medical Center
Jonesboro, GA 30236
Mailing address
3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-7070
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064850 | GA | MD | Family Medicine Physician |
| 64850 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1104134295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3495 PIEDMONT ROAD, NE",
"address_2": "NINE PIEDMONT CENTER",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30305",
"telephone_number": "404-364-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 MOUNT ZION PARKWAY",
"address_2": "KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER",
"city": "JONESBORO",
"state": "GA",
"postal_code": "30236",
"telephone_number": "770-603-3577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALIBERTE",
"first_name": "MATTHIEU",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-22",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "064850",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "64850",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.