Individual provider Active NPI

Vera Lafosse, D.O.

  • Family Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1104265016
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75308 Issued in GA
Practice address
1035 Southcrest Dr Ste 200
Stockbridge, GA 30281-6116
Phone
(770) 474-5302
Fax
(770) 474-1275
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 006482 GA
Family Medicine Physician 207Q00000X 75308 GA Primary

Addresses

Primary practice location

1035 Southcrest Dr Ste 200
Stockbridge, GA 30281-6116

Mailing address

1035 Southcrest Dr Ste 200
Stockbridge, GA 30281-6116
Phone (404) 836-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161116000805 GA Practitioner - Family Practice 9638312390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

1035 Southcrest Dr
Suite 200
Stockbridge, GA 30281-6116
Phone (770) 442-1911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
006482GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. Family Medicine CurrentSince May 5, 2025 Accepting new patients
Jencare Neighborhood Medical Center West End, LLC CurrentSince Dec 1, 2022 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

105 Carnegie Pl
Ste 103
Fayetteville, GA 30214
Phone (770) 716-7999

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

1035 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (770) 474-5302

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1104265016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 SOUTHCREST DR STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816116",
            "telephone_number": "404-836-0136",
            "fax_number": "404-850-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 SOUTHCREST DR STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816116",
            "telephone_number": "770-474-5302",
            "fax_number": "770-474-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFOSSE",
        "first_name": "VERA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "006482",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "75308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.