Organization Active NPI

Lafayette Neurology, PC

  • Neurology Physician
  • Lagrange, GA
National Provider Identifier
1164882635
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
58107 Issued in GA
Legal business name
LAFAYETTE NEUROLOGY, PC
Practice address
1075 Lafayette Parkway
Suite 210
Lagrange, GA 30241-3584
Phone
(706) 350-5525
Fax
(706) 350-5295
NPI assigned
Feb 26, 2016
Last updated
Aug 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Authorized official

Name
Ramona Burnside
Title
Office MGR.
Phone
(706) 350-5525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 58107 GA Primary

Addresses

Primary practice location

1075 Lafayette Parkway
Suite 210
Lagrange, GA 30241-3584

Mailing address

1075 Lafayette Parkway
Suite 210
Lagrange, GA 30241-3584
Phone (706) 350-5525

National Provider Directory

National Provider Directory

Locations

1075 Lafayette Pkwy
Ste 210
Lagrange, GA 30241
Phone (706) 350-5525

Practitioners & affiliated clinicians

Practitioners 1

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": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1164882635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 LAFAYETTE PARKWAY",
            "address_2": "SUITE 210",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302413584",
            "telephone_number": "706-350-5525",
            "fax_number": "706-350-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 LAFAYETTE PARKWAY",
            "address_2": "SUITE 210",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302413584",
            "telephone_number": "706-350-5525",
            "fax_number": "706-350-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE NEUROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "BURNSIDE",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "706-350-5525"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "58107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.