NPIMap

Organization Active NPI

Intown Family Practice & Sports Medicine PC

  • Primary Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1235446394
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
038777 Issued in GA
Legal business name
INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC
Practice address
285 Boulevard Ave NE
Suite 640
Atlanta, GA 30312-4212
Phone
(404) 577-7800
Fax
(404) 577-7810
NPI assigned
Sep 9, 2010
Last updated
Sep 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Authorized official

Name
Lawrence Leo Golusinski Jr., M.D.NPI 1790742526
Title
Owner
Phone
(404) 577-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 038777 GA Primary
Primary Care Clinic/Center 261QP2300X 20330 NC

Addresses

Primary practice location

285 Boulevard Ave NE
Suite 640
Atlanta, GA 30312-4212

Mailing address

285 Boulevard Ave NE
Suite 640
Atlanta, GA 30312-4212
Phone (404) 577-7800

National Provider Directory

National Provider Directory

Locations

285 Boulevard NE
Ste 640
Atlanta, GA 30312
Phone (404) 577-7800

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": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1235446394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD AVE NE",
            "address_2": "SUITE 640",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124212",
            "telephone_number": "404-577-7800",
            "fax_number": "404-577-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD AVE NE",
            "address_2": "SUITE 640",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124212",
            "telephone_number": "404-577-7800",
            "fax_number": "404-577-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTOWN FAMILY PRACTICE & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "GOLUSINSKI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-577-7800",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "038777",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "20330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.