Individual provider Active NPI

Lisa R Mack, MD

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1235153990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
47115 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2247
Phone
(404) 686-3845
Fax
(404) 686-4332
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 47115 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2247

Mailing address

531 Asbury Circle-Annex
Suite N340
Atlanta, GA 30322-0001
Phone (404) 778-5975

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
I20050531000123 GA Practitioner - Emergency Medicine 7719929884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47115GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Aug 1, 1999 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 1999 Accepting new patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Emory Medical Care Foundation Inc Emergency Medicine CurrentSince Jul 1, 1999 Accepting new patients
Morgan County Georgia Hospital Authority Current Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

531 Asbury Cir
Ste N340
Atlanta, GA 30322
Phone (404) 778-2624

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Interoperability endpoints

  • Direct secure messaging: lmack20055@direct.emory.org
  • Direct secure messaging: lisamack@mmc.medalliesdirect.net

Organizations & group practices 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235153990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ASBURY CIRCLE-ANNEX",
            "address_2": "SUITE N340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-778-5975",
            "fax_number": "404-778-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082247",
            "telephone_number": "404-686-3845",
            "fax_number": "404-686-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "47115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.