Forest Park Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FOREST PARK MEDICAL GROUP

Practice address

1019 Astor Ave
Forest Park, GA 30297-3532

Phone

(404) 366-9311

Fax

(404) 366-1250

NPI assigned

Jun 20, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa M Ganes, MA

Title

Insurance

Phone

(404) 366-9311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194920033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 ASTOR AVE",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973532",
            "telephone_number": "404-366-9311",
            "fax_number": "404-366-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 ASTOR AVE",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973532",
            "telephone_number": "404-366-9311",
            "fax_number": "404-366-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST PARK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GANES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "404-366-9311",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.