Redan Hairston Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REDAN HAIRSTON FAMILY MEDICINE

Practice address

8225 Mall Pkwy
Suite 250
Lithonia, GA 30038-6994

Phone

(404) 297-1818

Fax

(404) 297-1629

NPI assigned

Jun 30, 2006

Organization subpart

No

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

Authorized official

Name

Mary Cammack

Title

Practice Manager

Phone

(404) 297-1818

Specialties & licenses 1

Addresses

Other names 1

• Redan Hairston Pediatric & Adult Medicine, LLC Doing business as

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1235167982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY",
            "address_2": "SUITE 250",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386994",
            "telephone_number": "404-297-1818",
            "fax_number": "404-297-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY",
            "address_2": "SUITE 250",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386994",
            "telephone_number": "404-297-1818",
            "fax_number": "404-297-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDAN HAIRSTON FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "CAMMACK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "404-297-1818"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redan Hairston Pediatric & Adult Medicine, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Lithonia, GA
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• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.