NPIMap

Organization Active NPI

Family Medical Clinic of Lawrenceville

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1306013594
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042715 Issued in GA
Legal business name
FAMILY MEDICAL CLINIC OF LAWRENCEVILLE
Practice address
2522 Cruse Rd
C-2
Lawrenceville, GA 30044-2750
Phone
(678) 225-5540
Fax
(678) 225-5541
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Irandathy Rodrigo, MD
Title
Business Owner
Phone
(678) 225-5540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 042715 GA Primary

Addresses

Primary practice location

2522 Cruse Rd
C-2
Lawrenceville, GA 30044-2750

Mailing address

2522 Cruse Rd
C-2
Lawrenceville, GA 30044-2750
Phone (678) 225-5540

National Provider Directory

National Provider Directory

Locations

2522 Cruse Rd
Ste C1
Lawrenceville, GA 30044
Phone (678) 225-5540

2522 Cruse Rd
Ste C2
Lawrenceville, GA 30044
Phone (678) 225-5540

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12359/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1306013594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 CRUSE RD",
            "address_2": "C-2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442750",
            "telephone_number": "678-225-5540",
            "fax_number": "678-225-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 CRUSE RD",
            "address_2": "C-2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442750",
            "telephone_number": "678-225-5540",
            "fax_number": "678-225-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC OF LAWRENCEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "RODRIGO",
        "authorized_official_first_name": "IRANDATHY",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "678-225-5540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "042715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.