NPIMap

Organization Active NPI

Sandy Plains Medical Group, LLC

  • Pediatrics Physician
  • Marietta, GA
National Provider Identifier
1215889126
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SANDY PLAINS MEDICAL GROUP, LLC
Practice address
3225 Shallowford Rd Ste 1300
Marietta, GA 30062-7033
Phone
(678) 560-7160
NPI assigned
Feb 12, 2026
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Justin Glaeser
Title
Managing Partner
Phone
(678) 560-5278

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Family Medicine Physician 207Q00000X NU
Pediatrics Physician 208000000X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

3225 Shallowford Rd Ste 1300
Marietta, GA 30062-7033

Mailing address

3225 Shallowford Rd Ste 1300
Marietta, GA 30062-7033
Phone (678) 560-7160

National Provider Directory

National Provider Directory

Locations

3225 Shallowford Rd
Ste 1300
Marietta, GA 30062
Phone (678) 560-7160

Practitioners & affiliated clinicians

Practitioners 9

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": "1770854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1215889126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD STE 1300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627033",
            "telephone_number": "678-560-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD STE 1300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627033",
            "telephone_number": "678-560-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDY PLAINS MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-12",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "GLAESER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-560-5278"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.